FAQ: The Canadian Registered Nurse Examination (CRNE)

[NotReady4PrimeTime, RN]

there seems to be a lot of confusion and repetition on this forum regarding the canadian registered nurse examination. the most frequently asked questions and their replies have been compiled for you here.

• what is the canadian registered nurse examination? the crne is the national licensing examination for canadian nursing school graduates and nurses from other countries who wish to practice nursing in canada. the exam is designed to test basic competencies expected of a beginner registered nurse in canada. it is a paper and pencil examination comprised of about 200 questions. the exam will include a number of experimental questions that will not count toward your score. currently the exam is entirely composed of multiple choice questions and the time limit if 4 hours.
  
  
• what resources should i use when studying for the exam? the canadian nurses association offers two resources, canadian registered nurse exam prep guide and the learn™ crne readiness test. the can be purchased through the cna office. lippincott's crne prep guide and mosby's prep guide for the canadian rn exam are two other excellent choices. these books are available through amazon and chapters-indigo. none of them are cheap, but they're worth the money.
  
• how is the exam scored? for multiple choice questions there is only one correct response for each question. there may be responses that are similar or contain partially correct responses, but there will only be one absolutely correct response and each correct response is given one mark. the multiple choice section is marked by computer scan. the short answer questions have three parts. scoring is performed by a team of content experts based on the presence of correct responses matching those on the scorer's list of acceptable responses. marks are awarded on a scale from 0-3; part marks are possible for partially correct responses. however, multiple choice and short answer questions are weighted identically so in order to receive a mark for a short answer question, all responses must be correct. the two parts are scored separately; the total number of points achieved on the short answer questions are added up then divided by 3 to obtain the aggregate score for that section. the two sections are then added together to obtain the final mark.
  
  
• what's a passing mark on the crne? the standard passing score ranges from 59-68%. but the standard passing score is determined by the level of difficulty of the exam as established by the crne examination committee. each exam is set by the committee using a pool of thousands of stock questions created by nursing educators across the country. the pool of questions is constantly changing, as is the composition of the exam. no two exams are ever more than superficially similar. the actual mark achieved only matters as it compares to the standard set for that specific exam. results are reported to the candidate as either "pass" or "fail". occasionally the cna will provide a score to the failing candidate in an effort to assist with succeeding on subsequent attempts but generally speaking you will not receive a score.
  
• how do i apply to write the crne? only new canadian nursing school graduates apply to write the crne. if the applicant is a nurse educated outside of canada (ien), the candidate isn't applying to write the crne, but rather applying for a permit to practice nursing in the province where they live or wish to live. the college of registered nurses for the province will assess the candidate's education as compared to the provincially accepted standard, which is not required for new graduates of local nursing schools. if the candidate's educational preparation is acceptable, they are given permission to write the exam, after which they may apply for full licensure in that province. if the candidate's education and/or experience is not equivalent to the province's standard there are additional steps the ien must take before permission will be granted. the deadline for applications to write (which must include payment of all fees) is usually 90 days prior to the exam date. if you choose to rescedule your exam, it must be done in writing. there is a cancellation fee, depending on the province you're writing in that can range from 25-50% of the exam fee; how much they keep will be based on how close to the exam date you contact them to reschedule. if you wait until the last minute (
  
• why does it take so long to get the results? when i wrote the nclex i had my results in a week. the nclex is administered completely differently than the crne. it is a computerized exam that is graded as it's being written. the results are electronically communicated with the board of nursing from which the candidate received authorization to write from. once the bon has the results the candidate can have the results. in canada, the paper and pencil format slows things down. there are only a limited number of testing locations in each province due to population concentrations. all exams are then submitted by mail to the canadian nurses' association in ottawa to be scored. the scoring does not begin until all 10 provinces and 3 territories have submitted their exams. once the scoring is done, the results are collated by province and then communicated by mail with the college of nursing in the province where the candidate wrote the exam. the province is then responsible for communicating the results by mail to the candidate. the process usually takes between 4 and 8 weeks, depending on the time of year and the volume of exams submitted.
  
  
• why does it seem like the results are staggered? bc had their results early this year and ontario always seems to get theirs last, even though the cna is in ottawa. it would make sense that ontario would get their results first! you can blame canada post for some of that. the results are mailed to all of the colleges at the same time. how many times each package is handled depends on how many postal substations it passes through before it gets to its destination. i've seen it take a week for something to go from my home in a suburb of edmonton to an address a 20 minute drive away (having gone through two substations and one main post office), and i've seen it take less than 2 days for something to go from winnipeg to montreal (one substation and one main post office). another huge factor is the number of results each college handles. ontario is the most populous province and thus can be expected to have the greatest number of people writing and the greatest number or results to examine, document, collate and send out. the speed of all of this depends on how many people they employ to do the work. where does the money to pay these people come from? all those fees they charge applicants. ontario charges some of the lowest fees in canada... do the math.
  
  
• what happens if i fail the exam? that depends on the province. some will allow the candidate to continue to work as a graduate nurse as long as their temporary permit is kept current. others will revoke the temporary permit as soon as they know the candidate has failed. to find out how the provinces will respond, look at the sticky linking to the colleges of nursing.
  
  
• how many chances to i get to pass? no province will allow more than three attempts. the majority will require the passing of a nursing refresher course after the second unsuccessful attempt before giving permission to write the third time. three strikes and you go back to nursing school or choose another profession.
  
• if i fail the third time, can't i just be a practical nurse? no, not automatically. the college of practical nurses in your province will determine what you will have to do to qualify to write their exam. (yes, more exams.) lpns/ rpns are regulated health professions just as registered nurses are, and are held to the requirements set out in provincial legislation. and it's entirely possible that if you weren't able to pass the crne, you might not be able to pass the clpne either.
  
  
• i've already passed the nclex. why do i have to write the crne? the nclex has nothing to do with canadian nursing regulation at all. the exams are very different in many ways. canada has a single payer health care system; we take a different approach to health promotion and preventive medicine. the crne focuses on those competencies that will aid the candidate to integrate into the canadian health care system and contains a large psychosocial component. there is much less concentration on clinical knowledge and pathophysiology of diesase and more on communication and primary care. a candidate could answer 265 nclex questions correctly and still fail the crne.
  
• how can i get more information? contact the college of nursing in your province, or contact the canadian nurses' association. http://www.cna-aiic.ca/cna/default_e.aspx or read this fact sheet: https://www.crnbc.ca/registration/lists/registrationresources/crneinfobrochure.pdf
  
  

***addendum march 2, 2010***

as a result of ongoing crticism from iens as to the appropriateness and fairness of the crne the following has been included:

the crne examines the nurse's knowledge base and critical thinking skills. clinical competency will have been examined in the course of the university- or college-based education program the canadian candidate has completed. eligibility to write the crne for canadian nursing graduates is dependent on their successful completion of their nursing education program, both academic and clinical. for iens, the clinical portion of their practice will be measured by a substantially-equivalent competence assessment in most provinces.

the main reason why multiple choice exams are used to assess knowledge base is that it provides the most direct measurement of retention and understanding of concepts through the selection of the most correct response(s) to the question in the simplest and quickest way to grade. (it is very similar to the nclex written in the us in that sense.) the exam measures the minimum knowledge and critical thinking skills expected of a newly-graduated entry-level canadian nurse with no clinical experience outside of the education program. if you don't know why you're doing something, or what it will do for and to the patient, then you aren't practicing safely, no matter how competently you might practice a skill.

essay questions have their role in education but are much too subjective and difficult to distill actual understanding of concepts from. grading such essays is difficult to standardize and very time-consuming. people already complain about how long the exam results take to get back to them. and essays don't really demonstrate clinical competence any more than multiple-choice questions.

in a sense, the crne is also a test of canadian english literacy and an evaluation of the writer's comprehension of the canadian health care system. these facets are arguably almost as important to the safe practice of nursing as are knowledge base, critical thinking skills and clinical competence.

this is how canada has chosen to determine eligibility to practice nursing. it is a universally-accepted method of assessment of nursing knowledge in canada. it is universally accepted in canada that a candidate shall only be given three attempts to succeed at the exam. when a person chooses to seek registration as a nurse in canada it behooves them to accept the regulations in place, as would a canadian nurse seeking registration in the us, the uk, sweden, saudi arabia or any other country. except the philippines, since nurses who have not been educated in the philippines are not eligible for registration there under any circumstances whatsoever.

as they say, when in rome...

[RN_Canada]

Just to let you know that CRNE has undergone some changes for this year and the five year cycle for 2010 to 2015.

Blueprint changes include:

• more emphasis on electronic communication and how the nurse uses that and whether they know the parameters of confidentiality and other legal parameters affected by electronic communication. - You have to know the laws of Canada!
  
• Competencies are now 128 instead of 194 - but do NOT be fooled by this reduction. There is not less to know as some of the competencies have been combined into one ( like the one on ethics which used to be 8 different competencies and is now one.)
  
• fewer questions on the exam - this may seem like a favourable improvement but there is also less time. There used to be 6 hours to complete 300 questions and now there is about 4 hours to complete about 230 questions -- do the math you now get less time per question!
  
• a higher level of difficulty. Questions at the cognitive level of application and critical thinking now form a minimum of 40% (each) of the exam whereas they used to only be 30-40% (each). Questions at the lower cognitive levels of knowlege and comprehension are now at 10% or below.
  

These are substantial changes you should be aware of.