Monday, December 19, 2011

Further information on new CRNE exam in Canada

The College of Registered Nurses of BC (CRNBC) has released some further information on the development of a new nursing exam.

CRNBC is stating that the new exam will be able to accurately assess Canadian RNs through:

  • Studying nursing practice to ensure the exam assesses entry-level practice competencies
  • Including Canadian nurses in exam preparation
  • Include Canadian nurses for sensitivity and translation reviews of the examination
  • Ensure regulatory bodies are collaborating on the administration of the exam
  • Ensuring nursing educators and students have time to learn about the new examination

From the way CRNBC is presenting these future changes, it seems as though the exam will not be the NCLEX, rather a Canadian version of the exam, developed through the same organization that develops the NCLEX.  However, the differences between the new exam and the existing NCLEX are not yet clear.

The introduction of the new exam will be January of 2015.  Therefore Canadian students have 9 further examinations using the current CRNE.

Here are a list of the provinces that have stated they will be implementing this new examination.  This list appears to indicate the implementation of the exam will affect almost all of Canada.

  • Alberta
  • British Columbia
  • Manitoba
  • New Brunswick
  • Newfoundland and Labrador
  • Northwest Territories and Nunavut
  • Nova Scotia
  • Ontario
  • Prince Edward Island
  • Saskatchewan
There is no mention of the nurses in the Yukon, or Quebec (although Quebec has traditionally written a french language examination).

Here is a link to CRNBC's website so you can read more:

We will continue to update you as we learn more details.

PRIMED Educational Associates.

Wednesday, December 14, 2011

Canadian Nurses to be licensed using NCLEX! -Update

As many people have now heard, last week it was announced that as early as 2014 or 2015 the CRNE will be replaced with the NCLEX. 
You can read about this here:

In other words, starting in a few years, in order to become a nurse in Canada you will need to write the American nursing examination! 

While the reasons for this change are unknown, this has ignited a hot debate within the Canadian nursing community.  The Canadian Nursing Association feels this change will pull Canadian educated nurses to the United States, making it easier for nurses to travel and obtain work south of the border. 

Certainly it seems there is a risk of this, which is particularly contentious in current climate of a Registered Nursing shortage. 

While we haven’t been able to find a statement from the licensing organizations yet (such as nursing colleges or provincial associations), there are likely various reasons they have decided to move to the NCLEX.

While it may seem the switch to the NCLEX is an easy option, the NCLEX is a very different exam from the CRNE. 

Interestingly at PRIMED we find that many Canadian educated nurses struggle more with the NCLEX and many internationally educated nurse struggle more with the CRNE. 

Here is a breakdown on some of the differences between the CRNE and the NCLEX.



Anytime- Students book through the testing centre

Via computer- Students write the exam on computer

3 times/ year: the CRNE is administered winter, fall and spring yearly

Via paper/ pencil: papers are marked

Number of Questions

Exam ends when students reach passing or failing mark.  May end after 60-80 questions.

Questions can have multiple correct answers and students may be instructed to “choose all that apply”

200-220 questions.  200 questions, all are marked.  Students also have 20 test questions on top of the 200.  Mark is based on 200 questions.

Each question has 1 correct answer.

Cognitive Domains

Uses Bloom’s taxonomy for cognitive domain-
Describes the majority of the examination as being  “higher level of cognitive ability”.

Unclear if exam also covers affective domain.

Outlines 3 taxonomy levels:
Cognitive Domain
1.     Knowledge comprehension
2.     Critical Thinking
Affective Domain
1.     Attitudes and Judgments

Content of exam

NCLEX is organized into “Client Need” categories:
1.     Safe & Effective Care Environment
2.     Health Promotion and Maintenance
3.     Psychosocial Integrity
4.     Physiological Integrity

CRNE is organized into 4 Competencies:
1.     Professional Practice
2.     Nurse-Client Partnership
3.     Health & Wellness
4.     Changes in Health

Here is an example, taken from the NCLEX development website of an NCLEX sample question.  This question can easily illustrate some of the differences between the Canadian and American exams.

“The nurse is caring for a client in a long term care facility.  The client’s spouse asks the nurse a question regarding the client’s treatment plan.  Which of the following responses would be most appropriate for the nurse to make?

a.     I cannot give you information on any client.
b.     Can you verify the clients date of birth?
c.      Let me ask the primary health care provider to speak with you
d.     You should speak directly to the client about the treatment plan.

The NCLEX states that the correct answer is:
a.     I cannot give you information on any client

Many Canadian educated nurses might struggle with this question.
While we are taught that we cannot provide confidential client information to other people, we are also taught from a model of family centered care in which we try to share “complete and unbiased information whenever possible”.  In the CRNE this question would likely be worded differently, with an option for the nurse to extend a more family centered care perspective to the patients spouse.  The nurse who has prepared for the CRNE might expect to see something like:

“I’m unable to give you confidential information on your partner, but let me speak with your spouse so I can determine what he/she would like me to share with you”

Another difference is that much of the content covered in the NCLEX guides can fit within one of the Canadian competencies- the “Changes in Health” competency.  This is seen through an increased number of questions that are more clinically or process focused.  The NCLEX seems to offer fewer questions on communication and aspects of nurse-client partnership as outlined by the Canadian competencies.

The change from the Canadian RN exam to the NCLEX leaves many nurses, educators and students with outstanding questions. 

1.     How will Canadian content be included or accounted for in the exam
2.     Will curriculums need to be altered to ensure students achieve success on the licensing exam?
3.     What will the cost of the new exam be to students?
4.     Will this exam draw more Canadian nurses to the USA as the CNA fears
5.     How will this change be implemented
6.     How do we ensure Canadian nurses continue to meet the standards of practice for Canada when we are not examining on these standards?

PRIMED Educational Associates will continue to offer CRNE preparation and continue to monitor this situation as it develops.  We will update our students on the conversation as it unfolds.

In the meantime, we wish everyone continued success with their education and for those students writing the CRNE this winter 2012- time to get studying!

Happy Holidays,
PRIMED Education

Thursday, December 1, 2011

Vancouver CRNE Prep Help Available!

Spaces are now open for the Vancouver PRIMED CRNE review course. The weekend workshop is taking place January 14-15 at the downtown Vancouver SFU campus-Harbourfront centre.
If you are graduating student or an international student and would like some help in preparing for the February 1, 2012 CRNE then sign up for PRIMED's intensive two day prep course. For two full days PRIMED facilitators will lead through different areas of nursing to review fundamental content essential in critical thinking which is an area the CRNE examines you on. In addition, you will practice over 200 mock CRNE questions over the two days and be sent home with a 55 question exam with answers and rationales.
If you live outside Vancouver, you will be pleased to hear PRIMED is also offering courses in Lethbridge, Toronto and Calgary in January.
For more information or to sign up online please visit