Ugo Giguere, The Canadian Press

MONTREAL – The Order of Nurses of Quebec’s (OIIQ) stated willingness to adopt the American exam for admission to the profession is being viewed as a new rebellion against the higher education environment and technical training in nursing.

“There is a reasonable suspicion on our part,” says the President and CEO of the Federation of CEGEPs, Bernard Tremblay.

In his opinion, the behavior of the Order is downright “absurd” in presenting educational institutions with a fait accompli without speaking of its intention to introduce a new exam.

On Thursday, the OIIQ expressed its desire to adopt the test, known by its English acronym NCLEX-RN. This is the American standardized exam used in other Canadian provinces.

“It seems to me a response aimed at making people forget all the mistakes that the Order has made in recent years and the impact of its unfounded and methodologically flawed examinations,” he replies, recalling that people are currently suffering the consequences of this lack of rigor.

Bernard Tremblay is hoping for government action as he sees the Order rejecting the harsh criticism he has received in recent reports from the Commissioner for Admissions to Professions.

In addition, he accuses the arrangement of “not taking into account the students who are currently completing their studies”.

The Fédération des cégeps is part of the “Coalition to Maintain the Qualified DEC in Nursing”. A group that includes the Quebec Collegiate Student Federation (FECQ). Its president, Maya Labrosse, says she doesn’t understand OIIQ’s stubbornness when the university network offers much better access to education.

“In terms of the financial and geographic accessibility of the profession, there is no doubt that the university network is an important asset for enrolling nurses in the health network,” she pleads, pointing out that 46 of the 48 public CEGEPs use the DEC in the offer nursing.

Universities could never compete with the size of the class that CEGEPs produce each year. Maya Labrosse goes even further, accusing the Order of failing in its duty to protect the public in its campaign against higher education.

“If we denied nurses qualifications and denied them access, we would be depriving hundreds of nurses every year,” the FECQ spokesman claims.

At the Order of Nurses of Quebec, Director of Admissions and Registration, Chantal Lemay, reiterates that “an examination is not intended to verify training (…) but the ability to practice safely.”

She adds that regardless of the assessment method chosen, programs must prepare people to practice the profession. In their opinion, the decision to introduce the NCLEX-RN was more driven by the need to upgrade to meet North American standards.

Chantal Lemay assures that the exam and training files are “two different issues”.

The minister says “No!”

Bernard Tremblay is visibly angered by the OIIQ’s actions and insists that “it is not their job to determine the level of education, it is the job of the Minister for Higher Education”.

When asked about this, Minister Pascale Déry’s office made it clear that it was not in favor of raising the minimum threshold for access to the nursing profession.

“Abolishing the technical program is out of the question,” we were told. “We can’t do without all qualified graduates, they have to access the network quickly.”

The Minister’s Office also notes that the current context of labor shortages is sufficient to close the debate.

A decision already made

The OIIQ’s hasty decision appears at first sight to be in response to the Commissioner for Admissions to Professions’ report, which severely criticized the methodology of its current examination, which is not the case.

Work in this direction had started long before that, according to the order, which received a positive statement in this direction as early as May 2022, i.e. almost four months before the fiasco of the event in September 2022. The success rate is catastrophic: 45.4% finally led to an investigation by the commissioner for admission to professions.

However, in his second progress report, presented this week, the Commissioner warns the OIIQ against the temptation to turn to an exam developed by a third party, which the Order hopes to do with the NCLEX-RN.

Me André Gariépy writes that “an exam is more than a technical assessment tool” and that it “also reflects a vision of the profession against which we aim to assess a candidate’s suitability”.

As such, he insists on the importance of having an approach that is consistent with the context of practice and the healthcare network in Quebec. He also warns that by choosing the American option, you lose “some control over the professional standard.”

The Commissioner also mentions that such an approach must be carried out in collegiality with all partners involved in the education and health network, which the OIIQ seems to have overlooked.

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