Commissioner recommends delaying Quebec nurse exam amid concerns over high fail rate

MONTREAL — A preliminary investigation into why more than half of candidates failed Quebec's nurse licensing exam last fall has found "concerning elements" surrounding both the exam and student preparation.

André Gariépy, the commissioner who oversees access to professional orders, recommended that the next date to write the exam be pushed back while the probe continues.

"In the current state of knowledge on the situation of the exam and given the existence of concerns, it would be imprudent to oblige all candidates to appear at the next sitting of the March 2023 exam," he wrote in the interim report published Wednesday.

The report found that just 45.4 per cent of nursing students passed the Sept. 26 licensing exam, compared to a pass rate of between 63 and 96 per cent in previous sittings.

Gariépy said nursing students have largely blamed what they see as flaws in the exam, while the province's order of nurses has suggested student preparation could have been affected by the COVID-19 pandemic.

"At this stage of the investigation, it is premature to comment on the causes of the (low) success rate at the September 2022 session," he said.

"However, an initial analysis of all the information obtained recently reveals worrying elements both on the examination and on the training of the candidates."

The commissioner said that while it's too soon to say whether the exam itself or the training led to the high failure rate, it's likely students have been harmed.

For some students, Sept. 2022 represented their final chance to pass the exam, which can only be attempted three times. In addition to pushing back the next exam, Gariépy recommended that candidates who failed for the third time in September be allowed another chance to take the test.

Given the concerns, "it would be unfair to definitively exclude from the admission process candidates who had a third failure at the September 2022 session," Gariépy wrote.

The high failure rate came at a time when the province is struggling to hire and retain nurses to work in the overburdened health-care system. The commissioner said he received dozens of complaints about the exam.

The nurses' order said last fall that it would offer "additional measures" to support students in their path toward admission, but it ruled out relaxing the criteria for its exam. The order did not immediately respond to a request for comment.

This report by The Canadian Press was first published Jan. 18, 2023.

Morgan Lowrie, The Canadian Press