Quebec Order of Nurses: Majority failed English licensing exam

The results of the Quebec Order of Nurses' licensing exam are dismal for candidates in the profession who wrote it in English.

Only 47.3 per cent of students who wrote the English version passed, compared to 78.7 per cent of candidates who wrote the French version.

• Quebec Order of Nurses responds to exam translation concerns
• Quebec nursing students protest licensing exam

Quebec nursing students who complained there were translation problems on the exam say these results are even worse than they expected.

"Absolutely shocked. I'm still letting it sit in. I'm kind of appalled by it," said Stéphanie Desgagné, who graduated from Dawson College last spring and failed the licensing exam in September.

Desgagné is among more than 400 people who signed a petition stating there were language problems on the English exam, putting them at a disadvantage.

But the Quebec Order of Nurses says poor translation is not to blame. It has met twice with all English-language nursing schools to review parts of the exam and insists they reached a consensus.  

"After meeting with the teachers, it's obvious for us that there's no reason to cancel the exam because the translation was not misleading. They should have been able to answer those questions," said Lucie Tremblay, president of the Order of Nurses.

Not everyone at those meetings agrees.

"There were problems with the way terminology was used which are not the same terminology used in the English education, and there were problems with syntax and grammar that could have caused students to take more time ... so I do think there was a problem in the way the exam was translated," said Fiona Hanley, nursing program coordinator at Dawson College. 

More than translation problems

The Quebec Order of Nurses says it too was surprised by the difference, which it had never calculated, let alone examined in the past. 

Tremblay said the Order of Nurses takes the situation seriously and decided to look at results dating back to 2009. Most often results on the English version are lower than those from the French version, and the situation is getting worse.

"The results were lower and lower year after year. There was a bigger discrepancy this year but nevertheless there was always a reduction in the results of the English students," Tremblay said.

Tremblay listed three contributing factors.

• English students rarely attend the exam preparation session offered by the Order of Nurses because it is only offered in French. Later this year it will be offered in English.
• Fewer students who wrote the English version of the exam had done "externships" — summer work in a hospital which contributes to clinical experience, Tremblay said.
• "The textbooks being used in English institutions don't cover the scope of practice in Quebec and they don't use the specific  language we use in Quebec," she said.

Dawson College nursing instructor Rebecca Dyck is not satisfied with those answers.

She said fewer externships — which are harder to get given budget cuts in hospitals — does not explain this year's results, and she's not satisfied with the changes the Order of Nurses plans to implement.

"For the students who are going to write their next exam in March, there's very little," Dyck said.

"So this lack in accountability concerns me greatly. From last September to September 2014, it was a 22 per cent drop [in success rate on English exam]. That is statistically significant no matter how you twist it and that needs to be addressed by the [Order of Nurses]."

The Order of Nurses says a second translator will now check the English version of the exam before it's finalized and there will be more information available on its website in English.

By November the exam preparation course will be available in English and a newsletter with exam preparation tips will eventually be sent every two months.

But neither of those measures will help nursing candidates who will write the next licensing exam in March.

"They're just not doing anything about it. It just seems like these are Band-Aid measures and it just boggles the mind ... their lack of action boggles my mind," said Raphaël Bédard, a graduate of Dawson College who failed the exam in September.

Both Bédard and Desgagné are preparing to rewrite the exam in March, but are considering leaving Quebec to practise nursing in another province.