MONTREAL — Hundreds of nursing candidates have reportedly been stripped of their right to practice because their professional code artificially caused them to fail the exam. The Commissioner for Admissions to Professions reveals this in the second progress report of his investigation into the fiasco of the Order of Nurses of Quebec (OIIQ) examination in the fall of 2022.

In this second part of his analysis, Commissioner André Gariépy questions the reliability and validity of the test, but makes recommendations to remedy the situation.

Me Gariépy focused on the methodology behind the exam’s design and harshly criticized the OIIQ for its lack of rigor. The highlights of their second progress report state that “for several years the statistical reliability coefficient of the test has been low”.

He adds a little further that “the documentation normally used to create the exam and its validity has not been revised for more than a decade”, although significant changes have been made to the exam.

Worse, the Commissioner explains that “due to trust issues” in its own exam in 2021, the OIIQ would have decided to “systematically raise the passing grade above the grade established by the agreed methodology”.

Thus, this increase, which Me Gariépy considers unjustified, would have resulted in around 500 candidates failing the September 2022 exam. However, these prospective nurses were stripped of the right to practice without the Order being able to truly assess their competence.

“There are just as many prospective nurses who could have had their license in autumn 2022 and are involved in the health network,” he states in his report.

To remedy this, the Commissioner asks “that the results for September 2022 be recalculated on the basis of a revised and fully justified passing grade”.

The commissioner is also interested in the college’s inability to maintain a reasonable level of difficulty from exam to exam. He is also interested in the relevance of the questions for the exam and what we are really trying to assess.

To support him in his analytical work, the Commissioner appointed Dr. Jack Gerrow, a professional who worked on the development of tools for assessing dental skills and Professor Emeritus at Dalhousie University. It is his opinion that is damning to the OIIQ.

In particular, it can be read there that the “regulation does not contain any examination-specific analysis of the tasks of the nursing profession”.

It also reveals that in 2021 the Order’s Board ordered the addition of a “measurement error” because success rates exceeded 90%.

Elsewhere in the report, a quote from a document provided by the order mentions that “the test does not make it possible to determine whether the person is competent or not, but it does present an obstacle in terms of protecting the public”. .

Eight recommendations and a “roadmap” are presented to the order to help it address the shortcomings identified by the client. Above all, Mr. Gariépy proposes to hire an experienced psychometrician in order to restructure the methodology of his investigation.

Treasury Department President Sonia LeBel responded on Twitter by calling the issues raised in the report “worrying.” “I expect the Order (…) to implement the recommendation to recalculate the pass mark quickly. We cannot do without qualified nurses on site,” she added.

In a press release, OIIQ said it “takes note” of the new report and is giving it a few days to analyze its contents before making a decision.

In September 2022, only 51.4% of first-time applicants passed the entrance exam with a score of 55%. Including candidates who had already failed in the past, the overall pass rate dropped to 45.4%.

In the second report we learn something even more striking. Candidates trained outside of Quebec, whether in other provinces or other countries, achieved a 15% success rate.

Faced with these disproportionately high default rates, Commissioner Gariépy launched an investigation. In his first progress report, the commissioner pointed out that he had identified “concerning elements both in the examination and in the training of the candidates”.

In this context, the study of the quality of the training and preparation of the candidates continues. The results of this hypothesis will be published in a third progress report.

At the time the results were announced, the OIIQ had blamed the context of the pandemic for justifying an inadequate learning or exam preparation framework for students in the various nursing programs.

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