Quebec’s nursing exam pass rate leaps up to 92%

After abysmal Quebec nursing exam results in 2022 and 2023, 92 per cent of candidates passed this spring.

A total of 1,702 candidates passed the test, meaning they scored a minimum grade of 57 per cent. The exam was held on March 26 and was open to all candidates, regardless of how many times they have failed it.

This improved passing rate is a step in the right direction to improve the Quebec population’s access to care, the head of the province’s nursing order, Luc Mathieu, said in a news release.

In a statement, Quebec Treasury Board President Sonia Lebel’s office says efforts to improve the examination processes will continue.

“The objective is to ensure the integration of all qualified nurses into the health-care system,” the statement said.

The pass rates had dropped to 45 per cent in September 2022 and remained below average at 53 per cent in March 2023. In January, the nursing order’s annual report showed that it issued fewer permits in 2022-2023 than in the last decade.

Those exams came under much scrutiny. Many nursing students told CBC News the exam, offered by the Ordre des infirmières et infirmiers du Québec (OIIQ), did not reflect what they studied in school. 

Some nursing students, frustrated by the results, sought to pass the exam offered in other provinces and the United States — the National Council Licensure Examination for Registered Nurses (NCLEX-RN) exam.

Among them was Esther Ha. She failed the OIIQ exam twice before heading to Nova Scotia to take the NCLEX-RN exam there. That test made more sense, she said.

“The questions were, for example, ‘what would you do?’ and not, ‘what is the priority intervention?'” said Ha, who now works at the McGill University Health Centre.

Last May, LeBel, Health Minister Christian Dubé and Higher Education Minister Pascale Déry met with the nursing order to address the situation.

The failure of aspiring nurses was jeopardizing Quebec’s plans, as the province aims to recruit nurses from abroad to address shortages in the health-care system. For the various categories of candidates trained abroad, the pass rate has also improved.

André Gariépy, who oversees access to professional orders in Quebec, issued a report that found the unusually low pass rates were not attributed to the educational institutions but rather to shortcomings and weaknesses in the examination process.

“The reliability level of the questions in the exam is pretty minimal, and for a high-stakes exam like this one, it should be much higher,” he said.

The commissioner’s report calls for immediate modifications to the exam and an investigation into the training of nursing students. The report also concluded the passing grade requirement had been raised without justification.

In May of 2023, the OIIQ announced it would rely on the NCLEX-RN exam as an assessment tool starting in 2024.  At that time, the nursing order’s president said the regulatory body intends on improving “the existing examination by implementing some of the recommendations put forward by the commissioner.”

But then in February, the OIIQ suspended its plan to rely on the NCLEX-RN exam.