Controversy has broken out in nursing colleges across Canada as preparations are made to move to a single, continent-wide standardized exam for licensing registered nurses.

“The main thing is that nursing students across the country, since this announcement, have been voicing a lot of discontent and upset with the decision,” said Maggie Danko, western regional director of the Canadian Nursing Students’ Association and a third-year nursing student at the University of Alberta.

On Dec. 1, most provincial nursing regulatory bodies in Canada announced that they had selected the National Council of State Boards of Nursing, an American company, to create a new licensing exam for registered nurses. The regulatory bodies of Quebec and the Yukon have not signed on.

The new exam will be written online rather than on paper, which will allow prospective nurses to write whenever they want and for a lower fee than the current Canadian Registered Nurses’ Exam costs. The CRNE can only be written on three days out of the year. These dates are chosen by the Canadian Nursing Association, which provides the CRNE.

“We’re also concerned that this decision to switch to the American company has been made without proper consultation of some of the relevant stakeholders, such as students, who are the ones that write the exam,” Danko said.

It’s true that students were not included in the selection process for the new exam creator, says College and Association of Registered Nurses of Alberta CEO Mary-Anne Robinson.

“This is a licensing exam and typically those decisions are made by the licensing bodies or the regulators.”

Robinson maintained that it is “not at all” standard practice to solicit input from those who will be taking such a test, and expressed surprise that the CNSA has opposed the change.

“One of the considerations that the regulators had when we went out to an open bidding process for this exam was that we were looking for an exam that would improve accessibility for new graduates,” Robinson said. “So we thought that being able to write at their convenience… would be something that students would really appreciate.”

For Danko, however, convenience did not seem to be an important factor; rather, she was much more worried about the possible problems posed by an American company writing and profiting from the Canadian licensing exam for RNs.

Danko listed several complaints she says nursing students have brought to her and her organization’s attention, including the fact that an American corporation will profit from Canadian students; a worry that students’ information will be available to American authorities; and a lack of cultural sensitivity.

“Some of our concerns as well are that as it’s a Canadian-developed exam, [the current exam creators] do consider the unique cultural needs of Canada in the drafting of the exam. They really focus a lot on cultural competency, and also the bilingual aspect of our country, and not just simply translation between French and English.”

Robinson was emphatic in her response to these concerns, saying that the licensing exam for new nurses is not intended to test for cultural differences.

“Canadian culture is really made up of several subcultures,” she said, “as is the U.S. Clearly we can’t be creating an exam in either country that would bias one culture over another.

“In fact, studies that have been done comparing the current Canadian RN exam to the current U.S. exam show that they’re 93.1 per cent similar, and the differences are only related to [differences in legislation]. That whole notion that it’s not sensitive to cultural differences is actually nothing to do with the exam.”

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