Adoption of NCLEX-RN for licensure in Canada: Faculty concerns and implications for nursing education.

This paper highlights questions about Canadian nurse regulators' adoption of the U.S.-based NCLEX-RN examination, effective 2015, as the only route to initial registered nurse licensure in all jurisdictions, excluding Quebec. The decision for this change was made by the Canadian Council of Registered Nurses Regulators (CCRNR), an umbrella association of CEO's of provincial regulatory bodies in collaboration with the National Council of State Boards of Nursing (NCSBN). Adoption and implementation of this new policy was accomplished by the Council of each provincial regulatory body. This change, representing the first international adoption of NCLEX-RN, was deemed successful by CCRNR and NCSBN. However, the Canadian Association of Schools of Nursing (CASN) described the decision as unilateral and unwise, questioning the applicability of NCLEX-RN in the Canadian context, citing significant French language translation issues and unacceptable pass rates. Both authors have had extensive academic nursing experience in U.S. and Canada. Both had many conversations with Canadian colleagues who described the impact on nursing education as disastrous. Most of our American colleagues knew nothing about this change, but once informed, expressed some concerns similar to those of their Canadian counterparts. We suggest that international adoption of a US-based examination for initial licensure merits wider discussion by nursing faculty here and abroad.

The Adoption of NCLEX-RN in Canada: A Failure of Leadership at the Intersection of Nursing Regulation, Education and Practice.

This commentary presents perspectives of two senior nursing professors who have extensive faculty and leadership experience in both Canada and the United States. To understand more about how the adoption of the National Council Licensure Examination-Registered Nurses (NCLEX-RN) examination in Canada came to be, the authors conducted conversations with 29 Canadian nurse educators and nursing education and practice leaders. Based on these conversations as well as a review of published materials on the topic, the authors conclude that regulatory leaders failed to involve key leaders and stakeholders from nursing education and practice in this decision, and the resulting negative consequences have been borne primarily by the education and practice sectors. The authors argue that the NCLEX-RN adoption has introduced a misalignment into what had been a well-aligned model of education, regulation and practice in Canada and invite readers to consider the following discussion points. First, the NCLEX-RN has been designed to operate within a healthcare system that should not, by any reasonable argument, be replicated elsewhere; therefore, what are the contextual factors that led to the Canadian adoption of the NCLEX-RN? Second, American regulators stipulate that the examination must fit associate degree graduate competencies and that the additional knowledge and competencies gained at the baccalaureate level are irrelevant for licensure purposes; however, is this a fit for Canadian nursing licensure that requires the baccalaureate degree as an entry for practice? In conclusion, as American higher education in nursing now begins to move toward a competency-based model, further changes will have to be implemented to shape and frame the future of nursing education in the United States, and by extension, the future development of the NCLEX-RN within Canada's distinct historical, social, political and institutional context.

Nurses for Wisconsin: A Collaborative Initiative to Enhance the Nurse Educator Workforce.

Wisconsin, like much of the nation, is currently suffering from a growing nursing shortage. The University of Wisconsin-Eau Claire College of Nursing and Health Sciences, in partnership with the University of Wisconsin-Madison, University of Wisconsin-Milwaukee, and University of Wisconsin Oshkosh nursing programs, took advantage of a University of Wisconsin System Incentive Grant for economic and workforce development to address this problem. With a $3.2 million award, the Nurses for Wisconsin goal is to increase the number of baccalaureate registered nurses by expanding the nursing education capacity within the University of Wisconsin System. Nurses for Wisconsin is accelerating the preparation of nursing faculty by supporting nurses to enroll in doctor of nursing practice or nursing doctor of philosophy programs with pre- and postdoctoral fellowship awards ranging from $21,500 to $90,000 and the recruitment of faculty with a loan repayment program of up to $50,000. In exchange for the financial support, fellows and faculty must make a 3-year commitment to teach in a UW System nursing program. Two conferences for program participants are also funded through the award. The first conference was held in October 2014. The second conference is scheduled for summer 2015. With the first year of the 2-year project completed, this article describes Nurses for Wisconsin from inception to implementation and midterm assessment with a focus on lessons learned. A follow-up article addressing final outcomes and next steps is planned.