May Katharyn A, Singh-Carlson Savitri
Emerita Professor and Dean, School of Nursing at the University of Wisconsin-Madison, Madison, WI.
Professor and Fulbright Scholar, School of Nursing, San Diego State University, San Diego, CA.
Nurs Leadersh (Tor Ont). 2019 Dec;32(4):57-65. doi: 10.12927/cjnl.2020.26101.
This commentary presents perspectives of two senior nursing professors who have extensive faculty and leadership experience in both Canada and the United States. To understand more about how the adoption of the National Council Licensure Examination-Registered Nurses (NCLEX-RN) examination in Canada came to be, the authors conducted conversations with 29 Canadian nurse educators and nursing education and practice leaders. Based on these conversations as well as a review of published materials on the topic, the authors conclude that regulatory leaders failed to involve key leaders and stakeholders from nursing education and practice in this decision, and the resulting negative consequences have been borne primarily by the education and practice sectors. The authors argue that the NCLEX-RN adoption has introduced a misalignment into what had been a well-aligned model of education, regulation and practice in Canada and invite readers to consider the following discussion points. First, the NCLEX-RN has been designed to operate within a healthcare system that should not, by any reasonable argument, be replicated elsewhere; therefore, what are the contextual factors that led to the Canadian adoption of the NCLEX-RN? Second, American regulators stipulate that the examination must fit associate degree graduate competencies and that the additional knowledge and competencies gained at the baccalaureate level are irrelevant for licensure purposes; however, is this a fit for Canadian nursing licensure that requires the baccalaureate degree as an entry for practice? In conclusion, as American higher education in nursing now begins to move toward a competency-based model, further changes will have to be implemented to shape and frame the future of nursing education in the United States, and by extension, the future development of the NCLEX-RN within Canada's distinct historical, social, political and institutional context.
本评论呈现了两位资深护理教授的观点，他们在加拿大和美国都拥有丰富的教师及领导经验。为了更深入了解加拿大采用美国国家理事会执照考试 - 注册护士（NCLEX - RN）考试的缘由，作者与29位加拿大护士教育工作者以及护理教育与实践领域的领导者进行了交流。基于这些交流以及对该主题已发表材料的回顾，作者得出结论：监管领导者在这一决策过程中未能让护理教育与实践领域的关键领导者及利益相关者参与进来，由此产生的负面后果主要由教育和实践领域承担。作者认为，采用NCLEX - RN考试使得加拿大原本协调良好的教育、监管和实践模式出现了失调，并邀请读者思考以下讨论要点。其一，NCLEX - RN考试是为在一个医疗体系内运行而设计的，从任何合理角度来看，该体系都不应在其他地方复制；那么，促使加拿大采用NCLEX - RN考试的背景因素是什么？其二，美国监管机构规定该考试必须符合护理学副学士学位毕业生的能力要求，而在学士学位阶段获得的额外知识和能力对于执照颁发目的而言并不相关；然而，这是否适合要求以学士学位作为从业门槛的加拿大护理执照考试呢？总之，鉴于美国高等护理教育如今开始向基于能力的模式转变，必须实施进一步的变革，以塑造和规划美国护理教育的未来，进而影响NCLEX - RN考试在加拿大独特的历史、社会、政治和制度背景下的未来发展。
