Fair Registration Practices Report

Nurses (2016)

The answers seen below were submitted to the OFC by the regulated professions.

This Fair Registration Practices Report was produced as required by:

  • the Fair Access to Regulated Professions and Compulsory Trades Act (FARPACTA) s. 20 and 23(1), for regulated professions named in Schedule 1 of FARPACTA
  • the Health Professions Procedural Code set out in Schedule 2 of the Regulated Health Professions Act (RHPA) s. 22.7 (1) and 22.9(1), for health colleges.

Index

  1. Qualitative Information
  2. Quantitative Information
  3. Submission

1. Qualitative Information

a) Requirements for registration, including acceptable alternatives
i. Describe any improvements / changes implemented in the last year.
  1. Exam registration requirement

Amendments to Ontario Regulation 275/94 changed sections 2(1)2, 3(1)2, 4(1)3, 8.1, 9 and 9.1 about registration examinations for RN, RPN and NP applicants.

The changes include the following

For RN applicants:

  • RN applicants now have unlimited attempts on the National Council Licensure Examination – Registered Nurses (NCLEX-RN).
  • An RN applicant who writes Quebec’s OIIQ exam, which is approved and accepted by the College as meeting the exam requirement, must pass it within three attempts to use this exam to meet the exam requirement.
  • If an RN applicant fails three attempts on any of the other approved RN exams (e.g., CRNE or OIIQ exams), the applicant will still be eligible to write the NCLEX-RN without having to complete a new program.

For NP applicants:

  • NP applicants can now have three attempts to write each exam approved for their specialty. For example, an NP-Adult applicant now has three attempts to pass the Adult-Gerontology Primary Care Nurse Practitioner Certification Examination, as well as three attempts to pass the Adult Nurse Practitioner Examination.

With the regulation changes, RPN and NP applicants who do not pass the approved registration exam(s) within the maximum number of attempts, now have more options for meeting the education requirement and becoming eligible to retake the exam.

Visit http://www.cno.org/en/become-a-nurse/registration-requirements/ for more information.

2. Temporary Class registration requirement – Evidence of Practice

Amendments to Ontario Regulation 275/94 changed sections 5(2)(a) and 5(3)(a) regarding the the timing of completing a nursing program to meet the College’s evidence of practice requirement for registering in the Temporary Class.

Applicants can now meet the requirement if they completed their nursing program within the past three years, not just one year.

ii. Describe the impact of the improvements / changes on applicants.

For RN applicants:

  • Provides applicants with unlimited attempts on a valid and reliable exam without needing to complete a new RN program to become eligible for further attempts.

For NP applicants:

  • Allows applicants to maximize the number of attempts available on each exam within their speciality certificate before having to complete a new NP program to become eligible for further attempts.

The changes make the regulations consistent for applicants by:

  • expanding the options for meeting the education requirement for RPN and NPs to become eligible for further attempts on an approved registration exam;

  • providing RPN and NPs who fail the approved registration exam(s) and must complete a new program, with the same options as new applicants for meeting the education requirement to become eligible to attempt the exam; and

  • providing applicants to the Temporary Class the same options as other applicants for meeting the evidence of practice requirement.  

The College invited 108 RN applicants and 1 NP applicant who were previously refused registration after failing an approved registration exam three times, to reopen their application at no additional cost. These applicants will be eligible for further attempts on the approved registration exam relevant to their application.

iii. Describe the impact of the improvements / changes on your organization.

These improvements/changes enhance the College’s ability to determine that an applicant meets the requirements for registration in a transparent, objective, impartial and fair manner. As well, they give Council more flexibility for making evidence-informed decisions about exam requirements (such as determining the appropriate number of exam writes).

b) Assessment of qualifications
i. Describe any improvements / changes implemented in the last year.
  1. Evaluation by the Touchstone Institute

The College enhanced its evaluation of internationally educated nurses by Touchstone Institute as part of ongoing process evaluation and improvement, and to reflect changes to RN entry-to- practice competencies. The changes include:

  • Competency categories evaluated by either Multiple Choice Questionnaire (MCQ) or Objective Structured Clinical Examination (OSCE). To meet the competencies associated with a specific category, the applicant must achieve the required level in the MCQ or the OSCE.
  • The College sends applicants an Outcome Report prepared by Touchstone Institute after the evaluation. This report outlines specific levels and/or scores for each competency category.
  • The evaluation by the Touchstone Institute has changed to reflect achievement levels and scores.

Find more information at:http://www.cno.org/en/become-a-nurse/registration-requirements/education/faq-iencap/

2. Nursing education assessment

a) The College has changed the way it interprets results of nursing education assessments from the National Nursing Assessment Service (NNAS) for internationally educated RN and RPN applicants.

Previously, the College considered NNAS reports about applicants’ nursing education to be advisory only. College staff reviewed the reports and conducted additional assessments of education. Now, the College uses the results of the report to determine if an applicant meets the education requirement or needs additional assessment. When the report indicates that the applicant meets the required level of equivalence, the College will no longer conduct additional assessments. The applicants now meet the nursing education requirement and become eligible to write the registration examination.

For more information, visit: http://www.cno.org/en/become-a-nurse/registration-requirements/education/education-evaluation/.     

b) The College now offers a paper-based review of RN applicants’ nursing practice before they are referred to the Touchstone Institute for evaluation.

This provides applicants, who have identified gaps in their nursing education and who have any nursing practice, with an opportunity for the College to review their current and past nursing practice to determine if competency gaps are met.

c) Applicants have access to further evaluation options of their nursing knowledge, skill and judgment, whether or not they have nursing practice.

Specifically:

  • all RN applicants can complete an evaluation by Touchstone Institute
  • all RPN and NP applicants can complete the Competency Assessment Supplement (CAS)

For information, visit www.cno.org, click Become a Nurse, Registration Requirements and Nursing Education. Or see a FAQs at: http://www.cno.org/en/become-a-nurse/registration-requirements/education/education-evaluation/

3. Additional alternatives for meeting the nursing education requirement

  • RN applicants now have the option to complete other nursing education before, or instead of, being evaluated by Touchstone Institute
  • RPN and NP applicants now have the option of  completing other nursing education before, or instead of, completing the Competency Assessment Supplement (CAS)
ii. Describe the impact of the improvements / changes on applicants.
  • Streamlined  application process through:
    • better use of NNAS report results
    • enhanced education assessment options for applicants
  • Improved process consistency and fairness for all applicants by:
    • giving all applicants who have nursing practice the chance to address competency gaps through a paper-based review of their practice before further assessment is completed
    • enabling all applicants, whether they have practice experience or not, to access the additional option of the Touchstone or CAS evaluation as is relevant to their application.
  • Increased fairness by adopting alternatives for applicants to meet the nursing education requirement
  • Enhanced overall efficiency of assessment of internationally educated applicants through the Touchstone evaluation
  • Provided fair registration practices by applying the process changes to all new applicants and assessing the effect of the changes on all open applications
iii. Describe the impact of the improvements / changes on your organization.

The improvements/changes enhance the College’s ability to determine whether an applicant meets the nursing education requirement for registration in a transparent, objective, impartial, fair and timely manner.

c) Provision of timely decisions, responses, and reasons
i. Describe any improvements / changes implemented in the last year.

No changes this year

ii. Describe the impact of the improvements / changes on applicants.

No changes this year

iii. Describe the impact of the improvements / changes on your organization.

No changes this year

d) Fees
i. Describe any improvements / changes implemented in the last year.

The College decreased the fee for taking its RPN registration exam to $220 (+HST) (from $255 + HST). Applicants still pay a scheduling fee of $105 (+HST) directly to the exam provider. 

ii. Describe the impact of the improvements / changes on applicants.

RPN applicants pay a lower exam fee to the College.

iii. Describe the impact of the improvements / changes on your organization.

The change reflected the College’s decreased administrative costs, which resulted from moving to a computer-based exam.

e) Timelines
i. Describe any improvements / changes implemented in the last year.

No changes this year

ii. Describe the impact of the improvements / changes on applicants.

No changes this year

iii. Describe the impact of the improvements / changes on your organization.

No changes this year

f) Policies, procedures and/or processes, including by-laws
i. Describe any improvements / changes implemented in the last year.
  1. Including additional nursing education as evidence of nursing practice

To register as a nurse, applicants must have evidence of practice within the past three years. The College has noticed that many applicants return to school for further education after completing their initial program. As a result, the College now assesses information about any additional nursing education in which an applicant may have acquired recent nursing knowledge, skill and judgment.

Visit http://www.cno.org/en/become-a-nurse/registration-requirements/evidence-of-practice/ for more information about the evidence of practice requirement

ii. Describe the impact of the improvements / changes on applicants.

This improvement/change provides applicants with more options for meeting evidence of practice requirements.

iii. Describe the impact of the improvements / changes on your organization.

The improvements/changesenhance the College’s ability to determine if applicants meet the requirements for registration in a transparent, objective, impartial and fair manner. 

g) Resources for applicants
i. Describe any improvements / changes implemented in the last year.

To communicate information about changes, the College updated information for applicants on its website (www.cno.org) about the following registration requirements:

  1. Nursing education:
  • Revised information to reflect changes in the assessment process at: http://www.cno.org/en/become-a-nurse/registration-requirements/education/. Also updated relevant links.
  • Provided new details about completing additional education to meet the nursing education requirement at: http://www.cno.org/en/become-a-nurse/registration-requirements/education/completing-additional-education/.
  • Revised information about changes to the Internationally Educated Nurses Competency Assessment Program (IENCAP) at: http://www.cno.org/en/become-a-nurse/registration-requirements/education/faq-iencap/.
  • Revised information in FAQs: Competency Assessment Supplement (CAS): http://www.cno.org/en/become-a-nurse/registration-requirements/education/faq-competency-assessment-supplement/.

2. Evidence of practice:

  • Developed new information about the process at: http://www.cno.org/en/become-a-nurse/registration-requirements/evidence-of-practice/. Updated links to relevant information.
  • Created image to simplify process for RN and RPN applicants: http://www.cno.org/en/become-a-nurse/registration-requirements/evidence-of-practice/evidence-of-practice-rns-and-rpns/.
  • Created image to simplify process for NP applicants: http://www.cno.org/en/become-a-nurse/registration-requirements/evidence-of-practice/evidence-of-practice-np/.

3. Registration examination:

  • Updated information about changes to the Canadian Practical Nurse Registration Examination (CPNRE), which switched from a paper-based format to a computer-based format, at: http://www.cno.org/en/become-a-nurse/entry-to-practice-examinations/rpn-exam/.
  • Developed online webcasts for applicants and educators about the CPNRE and computer-based testing, as well as written communication, using Clear Language principles.
  • Added links to resources for preparing for the CPNRE, as well as to a guide and a computer-based exam demonstration.
ii. Describe the impact of the improvements / changes on applicants.

The new information ensures applicants have the opportunity to understand College processes (and changes to those processes) in a timely manner. Enhanced resources for the new computer-based RPN exam help orient applicants to the new format.

The changes are aimed at improving applicants’ understanding of College processes through consistent communication, as well as Clear Language principles of content and design. This helps to ensure processes are transparent.

iii. Describe the impact of the improvements / changes on your organization.

The additional information and changes enable the College to support effective and transparent communication with applicants.

h) Review or appeal processes
i. Describe any improvements / changes implemented in the last year.

No changes this year

ii. Describe the impact of the improvements / changes on applicants.

No changes this year

iii. Describe the impact of the improvements / changes on your organization.

No changes this year

i) Access to applicant records
i. Describe any improvements / changes implemented in the last year.

No changes this year

ii. Describe the impact of the improvements / changes on applicants.

No changes this year

iii. Describe the impact of the improvements / changes on your organization.

No changes this year

j) Training and resources for registration staff, Council, and committee members
i. Describe any improvements / changes implemented in the last year.
  • All new staff members complete an e-learning module about Human Rights legislation as part of their orientation to the College.  
  • The College’s Entry-to-Practice Intake Coordinator completed the Osgoode Hall Law School Certificate in Human Rights Theory and Practice.

As part of their annual orientation in 2016, members of the Registration Committee:

  • viewed the OFC’s new learning modules about fair access law
  • received an overview of the Human Rights legislation by Raj Anand, legal counsel
  • attended an information session about language and communication with Andrea Strachan, Director Communication Programs, Touchstone Institute
ii. Describe the impact of the improvements / changes on applicants.

These improvements/changes ensure College staff and Registration Committee members are aware that decisions about applicants must be made in a transparent, objective, impartial and fair manner, considering relevant human rights and fair access laws.

iii. Describe the impact of the improvements / changes on your organization.

Members of the Registration Committee gain:

  • enhanced understanding of their roles and responsibilities regarding human rights issues
  • in-depth knowledge about fair access legislation and its effect on ensuring that processes are transparent, objective, impartial and fair.
  • more informed understanding of factors affecting the language proficiency of internationally educated applicants.
  • College staff members with expertise in human rights and fair access laws who act as a resource for the College and the Registration Committee.
k) Mutual recognition agreements
i. Describe any improvements / changes implemented in the last year.

No changes this year

ii. Describe the impact of the improvements / changes on applicants.

No changes this year

iii. Describe the impact of the improvements / changes on your organization.

No changes this year

l) Other (include as many items as applicable)
i. Describe any improvements / changes implemented in the last year.

The format of the RPN exam changed from paper- to computer-based testing.

ii. Describe the impact of the improvements / changes on applicants.

The improvement/changes provide applicants with:

  • multiple testing dates;
  • testing centres available across Canada
  • the ability to self-schedule and reschedule with the exam provider
iii. Describe the impact of the improvements / changes on your organization.

The improvement/changes simplify operational processes by moving scheduling management to the exam provider.

Describe any registration-related improvements/changes to your enabling legislation and/or regulations in the last year

As outlined in section a, changes were made to Ontario Regulation 275/94.

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2. Quantitative Information

a) Languages
Indicate the languages in which application information materials were available in the reporting year.
Language Yes/No
English Yes
French Yes
Other (please specify)
Additional comments:
 
b) Gender of applicants
Indicate the number of applicants in each category as applicable.
Gender Number of Applicants
Male 1609
Female 10445
None of the above 0
Additional comments:
 
c) Gender of members
Indicate the number of members in each category as applicable. Select the option that best corresponds to the terminology used by your organization.
Gender Number of Members
Male 13189
Female 160929
None of the above 0
Additional comments:
 
d) Jurisdiction where applicants obtained their initial education
Indicate the number of applicants by the jurisdiction where they obtained their initial education1 in the profession or trade.
Ontario Other Canadian Provinces USA Other International Unknown Total
8305 659 123
India
1476
Philippines
1102
Iran
70
Pakistan
42
Nepal
41
Jamaica
32
U.K.
29
Nigeria
21
Israel
19
Australia
14
China
10
Lebanon
10
Ireland
7
Romania
7
Ghana
6
Jordan
6
France
5
Singapore
5
Brazil
4
Cameroon
4
Haiti
4
Korea
4
Belgium
3
Egypt
3
Ethiopia
3
Kenya
3
CÙte D'ivoire
2
Finland
2
Italy
2
New Zealand
2
United Arab Emirates
2
Albania
1
Algeria
1
Antigua And Barbuda
1
Austria
1
Barbados
1
Burkina Faso
1
Colombia
1
Congo, The Democratic Republic Of The
1
Cuba
1
Eritrea
1
Hong Kong
1
Moldova, Republic Of
1
Morocco
1
Norway
1
Palestinian Territory, Occupied
1
Rwanda
1
Saint Lucia
1
Saint Vincent And The Grenadines
1
S Arabia
1
S. Africa
1
Sri Lanka
1
Switzerland
1
Syrian Arab Republic
1
Trinidad
1
Tunisia
1
Uzbekistan
1
Zimbabwe
1
Total
2967
0
12054

1 Recognizing that applicants may receive their education in multiple jurisdictions, for the purpose of this question, include only the jurisdiction in which an entry-level degree, diploma or other certification required to practice the profession or trade was obtained.

Additional comments:
 
e) Jurisdiction where applicants who became registered members obtained their initial education
Indicate the number of applicants who became registered members in the reporting year by the jurisdiction where they obtained their initial education1 in the profession or trade.
Ontario Other Canadian Provinces USA Other International Unknown Total
7534 514 78
India
663
Philippines
403
Iran
24
Jamaica
24
Pakistan
16
Nigeria
12
Nepal
9
China
8
Korea
8
France
7
Israel
6
Lebanon
6
U.K.
6
Albania
3
Australia
3
Brazil
3
Jordan
3
Kenya
3
Portugal
3
Serbia
3
Sri Lanka
3
Ukraine
3
United Arab Emirates
3
Colombia
2
Ghana
2
Iceland
2
Kazakhstan
2
Netherlands
2
Poland
2
S. Africa
2
Bangladesh
1
Barbados
1
Belgium
1
Bulgaria
1
Cameroon
1
Congo, The Democratic Republic Of The
1
Croatia
1
Cuba
1
Dominica
1
Ethiopia
1
Grenada
1
Haiti
1
Hong Kong
1
Italy
1
Japan
1
Mauritius
1
Mexico
1
New Zealand
1
Norway
1
Panama
1
Romania
1
Russia
1
Rwanda
1
Saint Lucia
1
Taiwan, Province Of China
1
Zambia
1
Zimbabwe
1
Total
1263
0
9389

1 Recognizing that applicants may receive their education in multiple jurisdictions, for the purpose of this question, include only the jurisdiction in which an entry-level degree, diploma or other certification required to practice the profession or trade was obtained.

Additional comments:
 
f) Jurisdiction where members were initially trained
Indicate the total number of registered members by jurisdiction where they obtained their initial education1 in the profession or trade.
Ontario Other Canadian Provinces USA Other International Unknown Total
145535 8696 1553
Philippines
5926
India
4090
U.K.
1565
Poland
585
Hong Kong
521
China
473
Iran
442
Jamaica
420
Russia
413
Macedonia, The Former Yugoslav Republic Of
330
Romania
294
Israel
285
Pakistan
230
Nigeria
207
Korea
202
Australia
121
Lebanon
116
Guyana
89
S. Africa
89
Germany
87
Ghana
85
Trinidad
76
Sri Lanka
73
Czech Republic
68
Ukraine
64
Jordan
63
Ireland
61
Netherlands
54
Colombia
50
Kenya
49
Ethiopia
47
Haiti
43
Hungary
43
New Zealand
41
Japan
38
Nepal
36
Taiwan, Province Of China
36
Peru
34
Brazil
31
France
31
Zimbabwe
28
Bulgaria
27
Singapore
24
United Arab Emirates
24
Italy
22
Belgium
21
Sweden
19
Albania
18
Finland
18
Serbia
17
Barbados
16
Cuba
16
Portugal
15
Switzerland
15
Chile
14
Malaysia
14
Rwanda
14
Uganda
13
Grenada
12
Saint Vincent And The Grenadines
12
Thailand
12
Norway
11
Turkey
11
Cameroon
10
Mauritius
10
Uruguay
10
Zambia
10
Austria
9
Egypt
9
Bosnia And Herzegovina
8
Croatia
7
Denmark
7
Greece
7
Tanzania, United Republic Of
7
Uzbekistan
7
Afghanistan
6
Belarus
6
Burundi
6
El Salvador
6
Kazakhstan
6
Malta
6
Mexico
6
Moldova, Republic Of
6
Sierra Leone
6
Slovakia
6
Congo
5
Ecuador
5
Saint Lucia
5
Somalia
5
Venezuela
5
Algeria
4
Argentina
4
Azerbaijan
4
Botswana
4
Iceland
4
Iraq
4
Nicaragua
4
Saint Kitts And Nevis
4
Antigua And Barbuda
3
Congo, The Democratic Republic Of The
3
Dominica
3
Fiji
3
Latvia
3
Lithuania
3
Morocco
3
Tunisia
3
Bangladesh
2
Costa Rica
2
Djibouti
2
Eritrea
2
Georgia
2
Kuwait
2
Panama
2
Puerto Rico
2
Scotland
2
Spain
2
Sudan
2
Swaziland
2
Tajikistan
2
Armenia
1
Bahamas
1
CÙte D'ivoire
1
Guatemala
1
Kyrgyzstan
1
Lesotho
1
Mongolia
1
Myanmar
1
Qatar
1
S Arabia
1
Zaire
1
Total
18180
154
174118

1 Recognizing that applicants may receive their education in multiple jurisdictions, for the purpose of this question, include only the jurisdiction in which an entry-level degree, diploma or other certification required to practice the profession or trade was obtained.

Additional comments:
 
g) Applications processed
Indicate the number of applications your organization processed in the reporting year:
Jurisdiction where applicants were initially trained in the profession (before they were granted use of the protected title or professional designation in Ontario)
from January 1st to December 31st of the reporting year Ontario Other Canadian Provinces USA Other International Unknown Total
New applications received 8305 659 123 2967 0
12054
Applicants actively pursuing licensing (applicants who had some contact with your organization in the reporting year) 12238 1127 385 12374 0
26124
Inactive applicants (applicants who had no contact with your organization in the reporting year) 573 154 67 1909 0
2703
Applicants who met all requirements and were authorized to become members but did not become members 754 92 8 79 0
933
Applicants who became FULLY registered members 7534 514 78 1263 0
9389
Applicants who were authorized to receive an alternative class of licence3 but were not issued a licence 0 0 0 0 0
0
Applicants who were issued an alternative class of licence3 1366 7 0 4 0
1377

1 An alternative class of licence enables its holder to practice with limitations, but additional requirements must be met in order for the member to be fully licensed.

Additional comments:
 
h) Classes of certificate/license
Inidcate and provide a description of the classes of certificate/license offered by your organization.

You must specify and describe at least one class of certificate/license (on line a) in order for this step to be complete.

# Certification Description
a) General Class Description (a)

Most nurses registered with the College belong to the General Class. Both Registered Nurses and Registered Practical Nurses belong in this class.

b) Extended Class (Nurse Practitioners) Description (b)

The Extended Class is for RNs who have additional education and clinical experience that allows them to practise as Nurse Practitioners. Members in this class have an expanded scope of practice, with the authority to diagnose, prescribe medication, perform procedures, and order and interpret diagnostic tests.

c) Non-Practising Class Description (c)

The Non-Practising Class is for members who want to remain College members at times when they are not practising nursing in Ontario.

d) Temporary Class Description (d)

The Temporary Class is an option for applicants who have met all the registration requirements for the General Class except completing the registration exam. Members in this class are allowed to practise under defined terms and conditions. They can join the General Class after they pass the exam.

e) Special Assignment Class Description (e)

The Special Assignment Class is a time-limited registration for nurses who have an appointment as an RN or RPN with an approved facility in Ontario. Members in this class can only practise within the scope of their appointment and only under defined terms and conditions.

f) Emergency Assignment Class Description (f)

The Emergency Assignment Class comes into force when the provincial government declares an emergency and asks the College to issue Emergency Assignment certificates of registration to qualified nurses.

Additional comments:
 
i) Reviews and appeals processed
State the number of reviews and appeals your organization processed in the reporting year (use only whole numbers; do not enter commas or decimals).
Jurisdiction where applicants were initially trained in the profession (before they were granted use of the protected title or professional designation in Ontario)
from January 1st to December 31st of the reporting year Ontario Other Canadian Provinces USA Other International Unknown Total
Applications that were subject to an internal review or that were referred to a statutory committee of your governing council, such as a Registration Committee 356 14 32 830 0
1232
Applicants who initiated an appeal of a registration decision 35 1 0 49 0
85
Appeals heard 38 0 0 27 0
65
Registration decisions changed following an appeal 2 0 0 10 0
12
Additional comments:
 
j) Paid staff
In the table below, enter the number of paid staff employed by your organization in the categories shown, on December 31 of the reporting year.

When providing information for each of the categories in this section, you may want to use decimals if you count your staff using half units. For example, one full-time employee and one part-time employee might be equivalent to 1.5 employees.

You can enter decimals to the tenths position only. For example, you can enter 1.5 or 7.5 but not 1.55 or 7.52.

Category Staff
Total staff employed by the regulatory body 193
Staff involved in appeals process 4
Staff involved in registration process 38
Additional comments:
 

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3. Submission

Submission
I hereby certify that:
Name of individual with authority to sign on behalf of the organization:
Anne Coghlan
Title:
Executive Director and CEO
Date:
2017/02/21

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