A Closer Look at the Introduction of the NCLEX-RN in Canada.

In 2015, the nursing faculty across most of Canada were informed by provincial nursing regulators that the America-based National Council Licensure Examination-Registered Nurse (NCLEX-RN) was going to replace the Canadian Registered Nurse Examination for our nursing students to become registered as nurses. This change in the exam has presented a number of challenges to both faculty and students as they transitioned from a Canadian exam for the Canadian context to an exam that was originally formulated for nursing registration in the United States. This manuscript examines the differences in the Canadian and American healthcare systems; explores the variations in Canadian and American nursing practice and education; outlines concerns surrounding the use of standardized testing that panders to corporate interests, encourages "teaching to the test" and is costing nursing programs and nursing students considerable resources; and explores the controversy surrounding the validity of the NCLEX-RN in both Canada and the United States. This manuscript asks Canadian nursing leaders, educators, clinicians and researchers to question why Canadians have taken on this exam when Americans themselves state that this exam "gives a false and incomplete picture of practice readiness."

Ways of Knowing as a Framework for Developing Reflective Practice among Nursing Students.

Abstract Background:Nursing students face the challenge of developing a comprehensive understanding of the complex role of the registered nurse across various clinical settings. Frameworks such as the "ways of knowing", help students conceptualize and critically reflect upon important processes in their professional learning. However, the academic language used to describe frameworks can be challenging. PURPOSE: This manuscript has two purposes. First, to briefly describe the historical climate influencing the development of nursing as a discipline. Second, two clinical practicum scenarios in acute care and community-based care are explored with the application of Carper's four fundamental ways of knowing in nursing (empirical, aesthetic, self-knowledge, ethical), and Chinn and Kramer's fifth, emancipatory, knowing as foundational to developing reflexivity in clinical practice. CONCLUSION: These practical descriptions and concrete examples can assist students in incorporating the five ways of knowing into their reflective practice and thereby more fully develop their construct of nursing.

Skills and attributes required by clinical nurse specialists to promote evidence-based practice.

PURPOSE/OBJECTIVES: The purposes of this article were to describe the challenges that clinical nurse specialists (CNS) face in their role and to examine how CNSs describe the skills and attributes that are needed to promote the use of evidence-based practice (EBP) in their workplaces. This article is based on findings from a dissertation regarding how CNSs promote EBP in a western Canadian province. DESIGN: A sequential explanatory participant selection mixed-methods design was used for this study. SETTING: The study took place in a western Canadian province that has a population of 1 million people, with 42.7% of the population residing in the 2 largest cities. SAMPLE: The sample was drawn from a provincial registered nurse database. The sample for the survey was 23, and for the interviews, there were 11 participants. METHODS: The telephone survey contained 113 questions grouped into several subcategories. SPSS 18 was used to analyze the survey data. The semistructured interviews were conducted face to face, transcribed, and reviewed for recurrent themes. Interpretive description was used to analyze the themes. FINDINGS: The major challenges faced by CNSs are role strain, lack of support and resources, and role ambiguity. The skills and attributes required to be a CNS are graduate preparation, clinical expertise, and people/communication skills. CONCLUSIONS: Clinical nurse specialists can improve patient outcomes by promoting EBP; to do so, they need to work in supportive contexts that give those in the CNS role a set of clear role expectations. IMPLICATIONS: There are challenges faced by CNSs in Canada, and there is a need to strengthen the CNS's role by standardizing the regulatory requirements at a national level.