Regulatory area: Registration/Licensing

Specific Issue: Global shortages of Registered Nurses have been well documented by various organizations. Among the strategies to address the shortage, Alberta health regions launched international recruitment initiatives in 2007 and 2008 leading to the College and Association of Registered Nurses of Alberta (CARNA) experiencing a ten-fold increase in the number of applications from internationally educated nurses (IENs) over a short period of time.

The Learning from Experience: Improving the Process of Internationally Educated Nurses’ Applications for Registration (LFE) project seeks to use evidence from this peak application period to increase the efficiency of the IEN application process, while remaining committed to the principles of fairness, transparency, and public safety.

Evaluation Process: Data from IENs who have submitted applications to CARNA over four years (2008-2011) was gathered using existing CARNA database information and paper file review. Statistical analysis was conducted to investigate characteristics of applicants’ education, practice experience and other factors as they relate to assessment and registration outcomes. The resulting knowledge led to policy and practice changes to the CARNA IEN application for assessment process. Further analysis will be completed and outcomes will analyzed following an 18 month implementation period.

What was the outcome?:  To our knowledge, this is the first study using quantitative statistical analysis to investigate IEN application for registration characteristics specifically related to licensure processes and outcomes. Historically there has been a lack of research or other evidence used to inform regulatory practice. Processes and practices are often developed based on anecdotes or common practices. The primary objective of the project is the development of sustainable and improved processes, supported by evidence-informed policy. Analyzing past application data and identifying trends, strengths and gaps of IEN applicant characteristics will inform better, transparent and fair assessment processes, and improve the confidence in and efficiency of the process for IENs and stakeholders.

What are the key learnings?: The LFE Project is a five-year initiative (2011 - 2016). Currently, the project team has completed a systematic analysis of four years of data garnering statistical information on demographics and assessment outcomes, as well as modeling variables that may contribute success or challenges related to registration outcomes. These findings led to policy and practice changes in the IEN application for registration process including:
• revision of the IEN application for assessment policy;
• development of guidelines for initial assessment based on the project findings;
• the opportunity for some applicants to proceed directly to bridging education;
• progression through the bridging education reported to CARNA once complete, rather than course by course; and
• revision of process time limits.

CARNA also revised or developed new communication tools including website pages, the self-assessment tool, emails and videos to more clearly articulate requirements and expectations to applicants. This work will position the college to better respond to current and future IEN applications.

It is anticipated that other nursing regulatory bodies will be very interested in the outcomes of this research and the potential to apply the research process and/or findings to their own application for assessment processes. Results may also be of interest to governments, policy makers, competency assessment centres, bridging education providers and IENs themselves.

Key Contact:
  Cathy Giblin,
Registrar/Director, Registration Services

College and Association of Registered Nurses of Alberta

11620 168 Street, Edmonton, Alberta
Phone: 780-451-0043

Fax: 780-452-3276

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