Quebec nurse exam should be delayed, says commissioner investigating last year's high fail rate

Bénédicte Savard, a nursing sciences student at Université de Sherbrooke, said she hopes the nursing exam scheduled for March is further delayed while an investigation into last year's high fail rate is ongoing. (Radio-Canada - image credit)
Bénédicte Savard, a nursing sciences student at Université de Sherbrooke, said she hopes the nursing exam scheduled for March is further delayed while an investigation into last year's high fail rate is ongoing. (Radio-Canada - image credit)

Aspiring nurses in Quebec should not have to write the nurse licensing exam until an investigation into why its unusually high failure rate last year is completed, according to the commissioner whose office is conducting the probe.

André Gariépy, who oversees access to professional orders in Quebec, released a preliminary report Wednesday afternoon into last fall's nursing exam. The report said it had found "worrisome elements" surrounding both the exam and student preparation, including that some candidates may have experienced a prejudice.

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, according to the interim report.

Gariepy says nursing students have largely blamed a flawed exam, while the province's order of nurses has suggested student preparation could have been affected by the COVID-19 pandemic.

The commissioner says that while it's too soon to say whether the exam or the training caused the high failure rate, it's clear students have been harmed.

In addition to pushing back the next exam scheduled for March, he is recommending that candidates who were barred from the profession after failing for a third time in September should be allowed to try again.

Bénédicte Savard, who is studying nursing at the Université de Sherbrooke, said she was surprised by how difficult the exam was last fall.

Savard completed a technical certificate in nursing at the CEGEP de Sherbrooke last year and was given a scholarship by Quebec's professional order of nurses (known by its French acronym, the OIIQ), the order that oversees the licensing exam.

"It was a little paradoxical to receive that honour, but not to be able to obtain my nursing title," Savard said in an interview Wednesday.

She said she's relieved to hear the commissioner appears to be confirming her and her peers' suspicions that the exam process may have been flawed.

Delay would be a relief, says nursing student

"I knew something was — not necessarily wrong with it, I'm not sure how to say it — but something was weird about it. So, to see the investigation is moving forward is good news for us and really encouraging," Savard said.

Savard has been working in a hospital as a candidate to the nursing profession in oncology for some time already. Her functions are similar to that of a licensed practicing nurse, she said, except for not being able to oversee critical situations or work with interns.

The OIIQ said it would not be commenting on Gariépy's interim report before Thursday. The order defended itself in November, when the investigation was launched, saying its exam was not different from past years and it was developed by a panel of experts from clinical and university settings.

In the fall, the order said 54.6 per cent of students had failed the licensing exam written at the end of September. For those who took the test for the first time, the failure rate was 48.6 per cent — the highest rate recorded in four years.

Quebec Health Minister Christian Dubé said Wednesday evening his office was looking through the report.

Ryan Remiorz/The Canadian Press
Ryan Remiorz/The Canadian Press

"We hope the [OIIQ] seriously takes into consideration the recommendations. We want to recruit more nurses into our network. That is our greatest priority and we want to do it in collaboration with all our partners," Dubé said in an emailed statement to Radio-Canada.

Quebec is faced with a serious nurse staffing shortage in its public health-care network, which was illustrated this week when a sit-in by nurses at the Maisonneuve-Rosemont Hospital all but shut down its emergency room.

The nurses threatened to resign en masse if changes were not made to the unit's management team. Their unit head was swiftly shuffled out by the health board overseeing the hospital.

Also this week, nurses at Lakeshore Hospital in Montreal's West Island sent a letter to Dubé through their union, calling on him to fix the "extremely worrisome situation" at that hospital's ER.

Savard said nursing students know the situation in Quebec hospitals is dire, but that they want to be part of the solution.

"The labour shortage is scary, but I've been working in a hospital already for a little while now, so I know the conditions. It is difficult, but all we're asking is to work," she said.

"To have the door closed on us despite knowing we can do the job, that we are competent, is frustrating."