People are failing! Something needs to be done: Canadian students' experience with the NCLEX-RN

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.

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.

A qualitative study.

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

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.

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.