People are failing! Something needs to be done: Canadian students' experience with the NCLEX-RN.
BACKGROUND
Canada's nurse regulators adopted the NCLEX as the entry-to-practice licensing exam for Canada's registered nurses effective January 2015. It is important to determine whether any issues from this change emerged for nursing students in preparing for and taking this new exam.


OBJECTIVE
To explore the experiences of Canadian graduate student nurses who were the first to write the NCLEX examination for entry to practice in Canada, determine whether any issues with implementation were identified and how these could be addressed.


METHODS
A qualitative study.


METHODS
Thematic analysis of semi-structured interview data obtained through interviews with 202 graduate Canadian nursing students was the methodology employed in this study.


RESULTS
The predominant theme that emerged from the interview data was policy related issues that students identified with preparing for and taking the NCLEX. Sub-themes included: a) temporary test centre concerns, b) perceptions of American context and content on the exam, c) lack of French language resources and translation issues, d) the limited number of opportunities to write the exam, e) communication and engagement with regulators, f) financial costs incurred and g) reputational costs for the Canadian nursing profession.


CONCLUSIONS
The experiences of study participants with NCLEX implementation in Canada were less than positive. This is of critical importance given the pass rates for first-time NCLEX writers in Canada were reported as 69.7%, substantially lower than pass rates on the previous Canadian entry-to-practice exam.
Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Suite 130, Toronto, Ontario M5T 1P8, Canada. Electronic address: l.mcgillishall@utoronto.ca.
Linda
L
McGillis Hall
School of Nursing, University of Ottawa, Faculty of Health Sciences, Canada. Electronic address: michelle.lalonde@uottawa.ca.
Michelle
M
Lalonde
Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Suite 130, Toronto, Ontario M5T 1P8, Canada. Electronic address: jordana.kashin@mail.utoronto.ca.
Jordana
J
Kashin
D002170:Canada; D002983:Clinical Competence; D003142:Communication; D003365:Costs and Cost Analysis; D004521:Educational Measurement / Q000379:methods*; D006801:Humans; D007407:Interviews as Topic; D008008:Licensure, Nursing; D036301:Qualitative Research; D013338:Students, Nursing / Q000523:psychology*
Canada; Entry-to-practice; Examination; NCLEX-RN; Nurses; Nursing; Qualitative research; Students