Standardized Canadian Exam for Pre-Licensure Preparation: Collaborative Development

Bradley, Patricia

Thursday, July 14, 2011: 8:50 AM

Patricia Bradley, MEd, PhD, RN
School of Nursing, York University, Toronto, ON, Canada
Bonnie Jean Hobbins, MS, RN
Health Sciences, Elsevier, Houston, TX

Learning Objective 1: discuss the reasons for adaptation of a standardized exam with proven predictability for use by Canadian nursing programs to evaluate student registry testing readiness.

Learning Objective 2: evaluate elements of collaboration required for successful translation of exam items from United States use to Canadian nursing schools.

Purpose: The aim of this collaborative project was to develop a standardized Canadian Registered Nurse Examination for pre-licensure preparation that identifies students at risk, provides remediation content, and is predictive of student success. For more than 40 years nurse educators in the United States of America (U.S.A.) have used standardized tests to identify students who are at risk for national licensure failure and to direct remediation of content/concept knowledge. Additionally, standardized measurements can provide valuable data for curriculum evaluation.

Strength of the Evidence: Nine serial research studies have demonstrated highly predictive accuracy of the Elsevier HESI™ RN Exit Exams (90% to 91%) in the U.S.A. Currently no Canadian English translation of this exam is available.

Proposed practice change: To increase the pass rates on the Canadian Registered Nurse Examination (CRNE) among first-time writers through development of a standardized Canadian HESI™ Exam-RN conceptually equivalent for nursing students in Canada and matched to the National Entry-level Registered Nurse Practice Competencies (2008). According to the Canadian Nurses Association (2009) in 2008 the pass rate for first-time writers educated in Canada is 90% compared to 70% of internationally educated nurses.

Implementation: Faculty at York University Toronto in Ontario, Canada, assumed the role of editor-in-chief and content expert for the purposes of forward translation, verification, and back-translation. Nurse educators at Elsevier Assessment HESI™ Exams in the U.S.A. collaboratively built an electronic pool of test items. The Canadian HESI™ Exam-RN, 150-items composed of four competency categories will consist of a Kuder-Richardson Formula 20 of 0.91, average item difficulty of 0.68-0.70, and Point Biserial Correlation Coefficient of 0.16-0.18.

Evaluation: With translation completed, pilot testing and cognitive interviews are set for a group of Canadian graduate nurses in 2011. Continuous test statistics will be gathered for all Canadian cohorts and will be used for continuous quality improvement.

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