Calls continue for Quebec to ditch nursing exam after order reverses course

Soon after finding out he failed Quebec’s controversial nursing exam earlier this year, Vinh Duy Zaiser went right back to the examination room.

But this time, the nursing student took the NCLEX-RN – the American exam used everywhere else in Canada. And he passed.

“A few more points here and there would’ve been the difference, which makes it particularly harder to accept considering the work that was put into it,” Zaiser told CityNews.

Zaiser’s situation is far from uncommon. Many nursing students who have repeatedly failed Quebec’s test pass the NCLEX on their first try. They say the evaluation is more based on real-life situations.

In fact, massive examination failure rates have become a staple of the Quebec nurses’ order (OIIQ) exam. Only 45 per cent of candidates passed the 2022 test. That rose to 63 per cent in September 2023 after the OIIQ offered free access to exam prep tools.

“The 63 per cent in itself is not a high enough passage rate for an exam,” said Zaiser.

“I think the OIIQ tried to bolster the support for students. In the past, I believe hospitals didn’t have to provide that training.”

In contrast, 93 per cent of Canadian candidates passed the 2020 NCLEX exam.

Those low pass rates in Quebec led to an investigation by a commissioner tasked with ensuring fairness in entry exams to the province’s professions. The report, tabled in October, concluded the exam was flawed and was to blame for high failure rates.

That was contrary to what the OIIQ had been claiming since the start of the controversy, which was that the pandemic deprived candidates of valuable hours of laboratory training and adequate internship support.

The commissioner has asked that the OIIQ recalculate the marks of several previous exams, including the latest one in September.

Authorization for a class-action lawsuit was filed in October by a Montreal nursing student in hopes to represent all those who failed the exam at least once between January 2021 and September 2023.

WATCH: Quebec nursing student feels defeated by licensing exam

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Former nursing student Hailey Wildenmann was relieved when she found out she passed Quebec’s exam last month.

“With the reputation of the exam, hearing about it from last year and the students that took it the year before, there was a lot of stress,” Wildenmann said.

“I felt relieved but I also felt bad for the people who didn’t pass because I know some people who didn’t pass. They definitely deserved to. I think they’re great nurses. They’re working right now.”

Those who fail retain their right to practise as candidates for the nursing profession. But many, like Zaiser, may opt to write the NCLEX.

“As soon as I receive my official licence from the jurisdiction I did my exam in, I need to transfer it over to the Quebec Order of Nurses,” said Zaiser.

Quebec order flip flops on decision to switch

Growing calls for the OIIQ to switch to the NCLEX were initially met with resistance. Quebec’s professional order did eventually concede, saying it intended to adopt the American test in the spring of 2024.

The OIIQ then reversed course last month, saying it was suspending its plan to adopt the NCLEX-RN while it waited to see how the planned modernization of the CEGEP-level nursing program would play out.

“The OIIQ intends to complete this work before continuing any reflection concerning the NCLEX-RN exam. It is therefore suspending its actions in this matter,” the order wrote in a Nov. 15 news release.

“The exam needs to change,” Zaiser said. “I think the NCLEX is a much more viable option, much better assessment of students’ capacities as a nurse compared to the OIIQ.”