CA Board of Nursing

you know what, i'm getting sick and tired of people quoting how foreign-trained nurses have low pass rates on the nclex-rn and blaming it on the so-called substandard education in other countries. in fact, posting statements that go as far as being demeaning to the reputation of nurses who trained in the philippines. how can someone be so bold to make a blanket statement about the quality of nursing graduates from a country they have not stepped foot on nor experience for themselves first hand?

nclex pass rates for foreign educated nurses are much lower than us standards and this has been the case for many years. why is that? because the nclex-rn is specifically tailored for nurses who trained in the us setting. it's an entirely different exam from what nurses from other countries are used to. on top of that, there is also a language barrier that nurses from non-predominantly english speaking countries have to contend with. to blame poor pass rates on educational standards alone without looking at other factors is just plain ignorant.

just look at the statistics from the latest country-specific pass rates published by ncsbn from countries with the highest number of nclex examinees:

australia - 60.8%

canada - 66.9%

china - 42.1%

india - 36.4%

korea, south - 60.6%

mexico - 31.5%

philippnes - 42%

united kingdom - 42.1%

source is from 2009 data available at: https://www.ncsbn.org/10_2009nclexexamstats_vol50_web.pdf

what's the pattern here? all the nclex examinees from those countries have a much lower pass rate than us graduates. does that mean their educational system is inferior? i wouldn't assume that especially since some of those developed countries are represented. could it be that the nclex is not the same type of licensure examination that these foreign nurses are used to in their native countries? that's more likely a better answer. furthermore, notice that with the exception of south korea, the countries with the lowest pass rates above are those where english is not the primary language? could there be a language barrier? highly likely. could there be other factors we haven't even began to think about? absolutely. it takes someone who thinks logically and sees the whole picture to not make ignorant assumptions.

finally, please read this article published in minority nurse and ponder on what the article is saying before you make assumptions: http://www.minoritynurse.com/nclex-rn%c2%ae/does-nclex-rn%c2%ae-pass-test-cultural-sensitivity.

culturally-insensitive or not, foreign nurses who wish to practice in the us need to pass the nclex-rn in its current form. there's no going around that and frankly, no foreign nurse i know of is complaining about this requirement anyway. we are all willing to take this exam as offered in this country and those of us who are lucky enough to pass are the only ones who have the priviledge to practice anyway.

personally, i have passed the cgfns, nclex-rn, ccrn, csc, and acnp-bc on my first attempt. granted i took the acnp-bc after graduating from a master's degree here so i can't attribute my foreign bachelor's degree for that success. the truth is, i do not have problems taking exams but i will never assume that someone who doesn't pass a test on their first attempt either received inferior training or is not capable of being an excellent nursing professional.

The report you posted is from 2009, the NCLEX exam was adjusted in 2011:

Current stats not broken down by country are the following is for 2011

https://www.ncsbn.org/1237.htm

2011 -7,411 applicants 34.91 % pass first time internationally educated . A drop of 8% since 2009.

2009 21,435- 42.30% pass first time internationally educated .

2011 -10,178 applicant 21.42% Pass repeat internationally educated. A drop of 4% since 2009.

2009 - 9,187 24.67% ass repeat internationally educated.

Internationally educated nurses, where ever they come from are being educated to practice nursing in the country they are being educated. The international nurse's education is best evaluated by the country that the school is being based in. That being said, NCLEX is the min. requirement to practice nursing in the USA.

Reading the Canadian Board here, international nurses have to undergo an assessment and often time further training to practice Canadian Nursing. What appeals to me is prior to taking the CRNE a clinical assessment of skills need to be completed. International trained doctors applying to practice in the USA also have to undergo a clinical assessment ( this is also required of US trained Physicians) and fail at a my higher rate than US trained docs. In my opinion the Nursing system could benefit from a similar evaluation of all applicants.

I also believe that there should be a limit how many times you can repeat the exam, there are limits for doctors, Canadian Nurses, and some US states. I would say after 3 failures there needs to be re education of any professional internationally trained or not.

I am not saying that international nursing education is substandard, but it is not meeting the US standards of basic nursing care.

As far as cultural bias the article was written in 2003, the NCLEX has been revised many times, but NCSBN response was:

"What does the National Council of State Boards of Nursing have to say about all this?

“The [NCLEX-RN] includes effective checks to minimize the potential for bias due to culture, gender and other background factors,” NCSBN maintains. “It is important that each [question] development panel is composed of nurses representing each region, a variety of practice areas, and minority populations. . .

“Differential item functioning (DIF) is the statistical approach [we use] to determine potential bias. [Questions] flagged for high levels of DIF are reviewed by a group of trained sensitivity reviewers, consisting of at least five members: one male, one representative of three of the ethnic focal groups of NCLEX examination candidates, one member with prior experience on a DIF Review Panel [and] one member with a linguistic background. . .The panel’s recommendations are forwarded to the Examination Committee for final disposition of the items. Additionally, judgments of trained individuals are used to screen [questions] for potential bias.”

In addition to the numerous content reviews conducted by the NCSBN and its member boards of nursing, the National Council also does two formal reviews looking exclusively at issues of cultural sensitivity, adds Casey Marks, PhD, director of NCBSN Testing Services.

When asked if he believes minority nurses may have more trouble passing the NCLEX than their majority counterparts, Casey answers: “We have no reason to suspect that individuals of the same ability level have anything but equal opportunity to pass the examination at the same rate, regardless of their cultural, ethnic, linguistic or racial background.”

ho-hum, you basically reposted what I already posted.

and BTW, there's no country breakdown on the 2011 data, if you really read it.

I don't agree with your opinion when you said:

"I am not saying that international nursing education is substandard, but it is not meeting the US standards of basic nursing care". That statement is a slap in the face to numerous other internationally-trained nurses who have moved up to become successful in the US.

Time to hit the ignore button.

Well, I think California is not going to budge on this. It's been set and implemented. Any RN applicant (specifically from the Philippines) who completed their OR, L&D, and Newborn Nursery cases outside of the Level Year or Semester when lectures on Surgical Nursing and Maternal-Child Nursing were offered do not qualify for licensure because the cases were not done concurrently with lectures. Hard pill to swallow but that's a decision that's hard to argue especially with a Board of Nursing. Sad part is it will disqualify graduates from excellent schools that really made sure students took time to complete 10 deliveries (5 actual, 5 assist), 10 OR cases (5 minor, 5 major), and 5 umbilical cord care on actual patients even if it took the whole Level 4 senior year to complete the cases. Even sadder, the terrible schools will just send fudged records to make it look like the cases were done concurrently with lectures.

Licensure os a function of state not federal government.Many states board of healthcare / nursing regulations do not permit prescreening of nursing candidates to see if they meet board of nursing standards. That can only occur AFTER one submits application for licensure. Entire application package is reviewed after NCLEX exam is taken with results sent to candidate.

spoke with the analyst in charge of my application and she is requesting for a letter from my school explaining why some of my cases were completed several semesters after the theory classes. she said she will re-evaluate my documents once that letter is received. i doubt her decision will change about my eligibility but it's worth a shot. i hope everything else besides the clinical cases is fine. the non concurrent issue was the only thing mentioned in her letter.

if that doesnt work, then it's on to the next state NJ and NY thanks for all of the replies, the positive and even the negative ones that seemed to look down on education in the philippines

At least they're willing to revisit your case. If they let you retest, then there's nothing to worry about for the other applicants from the Philippines who are in the same boat. Hopefully, it works out. If not, best bet is to apply in states that utilize CGFNS CES. CGFNS takes a long time to process but they've been in the business of credential evaluation for foreign trained nurses and they know what they're doing. Good luck.

Licensure os a function of state not federal government.Many states board of healthcare / nursing regulations do not permit prescreening of nursing candidates to see if they meet board of nursing standards. That can only occur AFTER one submits application for licensure. Entire application package is reviewed after NCLEX exam is taken with results sent to candidate.

BON's review the application documents before even allowing the candidate to take the NCLEX. Candidates can not register to Pearson-Vue without having all requirements submitted and approved by the BON. In the case of California, they claim that a license is automatically released as soon as the candidate passes the NCLEX-RN because they already checked the candidate's credentials to see if they match California's requirements.

From the BRN website: