Evidence of Practice

What is evidence of practice (EOP)?

“Evidence of practice” refers to any information that shows CNO that you have experience practicing as a nurse or nursing education within the past three years. You must provide this evidence before you can be registered with CNO.

The evidence must be relevant to the category or class of nursing you are applying to register in. For example, an applicant applying to become a Registered Nurse (RN) must provide evidence of practicing as an RN within the past three years before CNO can issue a certificate of registration.

What is nursing practice?

The activities that CNO will consider as evidence of nursing practice are diverse. They are not limited to a specific role, title or practice setting, or performing a specific procedure or activity.

The Nursing Act, 1991 defines the practice of nursing as:

The promotion of health and the assessment of, the provision of care for and the treatment of health conditions by supportive, preventive, therapeutic, palliative and rehabilitative means in order to attain or maintain optimal function.

Nursing practice includes opportunities to use nursing knowledge, skill, and judgment in:

clinical roles: providing direct patient care
non-clinical roles: such as working in education, administration, policy or research roles.

CNO doesn’t recognize time spent caring for a friend or family member as nursing practice for meeting CNO’s evidence of practice requirement.

How can I meet the EOP requirement as an applicant?

The requirements for each type of nurse: Registered Practical Nurse (RPN), Registered Nurse (RN) and Nurse Practitioner (NP) are outlined in detail further below.

Many CNO applicants meet the evidence of practice requirement by completing a CNO-approved nursing program within the past three years.

Evidence of practice can also be demonstrated in these ways:

You have practice experience as an RN, RPN or NP within the past three years (which must be relevant to the category or class of nursing to which you are applying).

Nursing work outside Ontario can be considered nursing practice that meets the requirement, however, it must be attained through employed or paid roles rather than volunteer practice (except for labour mobility applicants). If required, you must be registered with the nursing regulatory body or authority in the jurisdiction where you were or are currently practicing. You will be required to provide a verification of nursing practice form from your employer/agency and verification of registration form from your regulatory body/nursing board. Your verification of nursing practice must include:

Past or current position(s) in nursing (for example, staff nurse, researcher, educational instructor)
practice setting(s) (for example, long-term care, acute care hospital, in-patient unit, nursing school, research organization)
patient population(s), if applicable (for example, geriatrics, pediatrics)
job description(s) if you were practising as an NP for your previous nursing roles

You have completed other nursing education within the past three years. Your program must have included both theoretical and clinical components (for example, opportunities to apply and demonstrate your nursing knowledge, skill and judgement in real life) relevant to the category to which you are applying. For example, you have completed:

a Post Basic Bachelor program outside of Ontario with a clinical component

a Masters of Nursing or PhD in nursing involving research, publication, conference, or component demonstrating practical application of your nursing knowledge, skill and judgement.

Labour mobility applicants

For labour mobility applicants who are registered in a Canadian jurisdiction outside of Ontario and are applying for an equivalent nursing certificate in Ontario, EOP is not a requirement for registration. However, labour mobility applicants will be required to show EOP after their registration. When CNO’s Registrar & CEO requests EOP from labour mobility registrants, including but not exclusive to those who are automatically recognized, that practice experience can include paid positions and may also be demonstrated through volunteer roles and activities within the last three years

I’m an applicant who has not practiced within the past three years. What can I do to meet the EOP requirement?

If you do not have evidence of practice within the past three years, you may still be able to meet this requirement by:

demonstrating practice in another jurisdiction where you are registered as RN, RPN or NP. The practice experience must be obtained through employed or paid roles rather than volunteer practice.
Completing the Registered Nurses Canadian Competency Assessment Program (RNCCAP), which is an evaluation administered by Touchstone Institute for RNs who are looking to meet the nursing education requirement.
supervised practice experience partnership (SPEP) in Ontario. Read about the Supervised Practice Experience Partnership for more details about the program and eligibility requirements.
Supervised clinical practice experience in Ontario as an NP. For more information, please contact us by email at cno@cnomail.org.

Supervised Practice Experience (SPE) as a reinstating applicant who is registered in the Non-Practising Class. Read about the Supervised Practice Experience for nurses returning to practice.

successfully completing:

Any additional education that an applicant undertakes, either independently or as directed by CNO.

For RN applicants:

You can meet the Evidence of Practice requirement for RNs in any of the following ways:

You completed nursing education that meets the nursing education requirement within the last three years.
You practiced (in a paid position) as an RN within the last three years
CNO has received other information about your experience or nursing education within the last three years and determined that it meets the evidence of practice requirement
You have returned or will return to another jurisdiction to practice as an RN
You have successfully completed the additional education that CNO has asked you to complete to meet the evidence of practice requirement

See the section below, “RN applicants: Meeting EOP through other education options,” for more details.

For RPN applicants:

You can meet the Evidence of Practice requirement for RPNs in any of the following ways:

You completed nursing education that meets the nursing education requirement within the last three years
You practiced (in a paid position) as an RPN within the last three years
CNO has received other information about your experience or nursing education within the last three years and determined that it meets the evidence of practice requirement
You have returned or will return to another jurisdiction to practice as an RPN
You have successfully completed the additional education that CNO has asked you to complete to meet the evidence of practice requirement

See the section below, “RPN applicants: Meeting EOP through other education options,” for more details.

How do I verify my employment experience for EOP?

If you are trying to meet EOP with employment experience as a nurse within the past three years, you must submit a verification of nursing practice form from your employer/agency directly to CNO that provides evidence of recent nursing practice. CNO will assess the information you provide to determine whether you meet the evidence of practice requirement.

Your verification of nursing practice must include:

past position(s) in nursing (for example, staff nurse, researcher, educational instructor)
practice setting(s) (for example, long-term care, acute care hospital, in-patient unit, nursing school, research organization)
patient population(s) if applicable (for example, geriatrics, pediatrics)

If you were previously registered in another jurisdiction, CNO also requires

a Verification of Registration form from your regulatory body/nursing board with evidence of registration in the jurisdiction(s) where you were registered for the time you practiced there
job description(s) if you were practising as an NP for your previous nursing roles

NP Applicants

You can meet the Evidence of Practice requirement for NPs in any of the following ways:

You completed NP education that meets the nursing education requirement within the last three years
You practiced in a clinical NP role within the past three years in the specialty you want to register for

Practical experience in a clinical NP role includes:
interacting directly with client population(s) consistent with the specialty certificate you want to register for

and

using advanced nursing knowledge and decision-making skills in health assessment, diagnosis and therapeutics when treating those clients
CNO has received other information about your experience or nursing education (or other courses taken) within the past three years as an NP in the specialty you want to register for, and determined that it meets the evidence of practice requirement
You have returned to another jurisdiction to practise as an NP in the specialty you want to register for
You have completed additional education as an NP in the specialty you want to register for, which CNO asked you to complete

If you are a Nurse Practitioner (NP) applicant who is not a recent nursing graduate and CNO asks you to provide evidence of recent nursing practice, it must include:

past or current position(s) in nursing (for example, staff nurse, researcher, educational instructor)
practice setting(s) (for example, long-term care, acute care hospital, in-patient unit)
patient population(s) (for example, geriatrics, pediatrics)
evidence of registration in the jurisdiction(s) where you practiced
job description(s) for your previous nursing roles

You must submit the required Verification of Nursing Practice completed by your nursing employer, along with a Verification of Registration completed by the regulatory body in the jurisdiction in which you practice. CNO will assess all information you provide to determine whether you meet the evidence of practice requirement.

RN applicants: Meeting EOP through other education options

Registered Nurse (RN) applicants who have not practiced in three – 10 years must complete:

400 hours of clinical/practical/consolidation experience

and

nursing course content related to cultural context, computers, technology, pharmacology, practice standards, health assessment, legal/ethical issues, gerontology and communication.

RN applicants who have not practiced in 10 – 15 years must complete:

600 hours of clinical/practical/consolidation experience

and

nursing course content related to cultural context, computers, technology, pharmacology, practice standards, health assessment, legal/ethical issues, gerontology, mental health, crisis management, family-centred care, nursing research, nursing theory/framework, leadership, advanced communication and community.

RN applicants who have not practiced in more than 15 years must complete:

400 hours of clinical practice

and

300 hours practical/consolidation experience

and

nursing course content related to cultural context, computers, technology, pharmacology, practice standards, health assessment, legal/ethical issues, gerontology, mental health, crisis management, family-centred care, nursing theory/framework, leadership, advanced communication and community.

Advanced standing

You may ask the school whether they can assess your previous education, experience and knowledge (also known as a Prior Learning Assessment Recognition, or PLAR). If you receive advanced standing, the school must indicate this on CNO’s Verification of Course Completion form and provide a letter explaining why it gave you advanced standing.

Applying as both an RN and RPN

If you are applying for registration as both an RN and RPN, you will meet the requirement for both applications by completing the theoretical and clinical practicum and consolidation hours that your RN application requires.

RPN applicants: Meeting EOP through other education options

Registered Practical Nurse (RPN) applicants who have not practiced in three to 10 years must complete:

400 hours of clinical/practical/consolidation experience

and

nursing course content related to cultural context, computers, technology, pharmacology, practice standards, health assessment, legal/ethical issues, gerontology, communication (including mental health strategies), family-centred care, growth development across the life span, chronic illness and hospitalization effects on the family and family dynamics, nursing theory/framework, leadership and anatomy/physiology/pathophysiology.

RPN applicants who have not practiced in more than 10 years must complete:

600 hours of clinical/practical/consolidation experience

and

nursing course content related to cultural context, computers, technology, pharmacology, practice standards, health assessment, legal/ethical issues, gerontology, communication, family-centred care, growth development across the life span, chronic illness and hospitalization effects on the family and family dynamics, nursing theory/framework, leadership and anatomy/physiology/pathophysiology.

Advanced standing

Evidence of practice as an NP

NP applicants must meet the same evidence of practice requirement as other applicants, with one exception: they must demonstrate evidence of practice as an NP.

This can be done by completing one of the following:

meeting the educational requirement for registration as an NP

practicing in a clinical NP role: this must have included direct interaction with client population(s) for each desired specialty certificate; the applicant must have used advanced nursing knowledge and decision-making skills in health assessment, diagnosis and therapeutics when treating those clients

For NP applicants, CNO considers whether your recent nursing practice includes:

clinical practice as an NP

and

a nursing role that required you to use advanced knowledge and decision-making skills in assessment, diagnosis and therapeutics when treating patients.

Additional training/education to meet the NP EOP requirement

If you don't meet the evidence of practice requirement, you have the option to complete additional education or training in the form of supervised clinical practice completed through:

Nursing schools (for example, Athabasca University) offering supervised clinical practices opportunities for NPs via a formal program or course. This is arranged through the school; or
a self-selected NP supervisor, approved by CNO, who works independently or as part of an organization.

The supervised clinical practice must:

be reflective of the NP role in Ontario
include a client population relevant to the specialty certificate that an NP applicant is applying for
involve advanced knowledge and decision-making skills in health assessment, diagnosis and therapeutics when treating clients
apply the entry-level competencies for NPs
be supervised by an NP

If you elect to do it through a school, then the school and the applicant must collaborate to:

identify an NP who holds a specialty certificate that is consistent with the one in which the applicant is seeking registration to be a mentor;
identify an organization or opportunity where the applicant can participate in a supervised clinical practice with a client population that is relevant to the applicable NP specialty certificate; and
collaborate with the NP supervisor to conduct an assessment of the applicant’s practice related to the applicant’s ability to apply the NP entry-level competencies and develop a learning plan with goals based on the assessment.

If you elect to complete your NP supervised clinical practice by arranging it yourself by identifying an NP supervisor, you must arrange for the selected NP supervisor to submit the following information directly to CNO for review:

information about themselves and the organization, if applicable
a description of roles and responsibilities that will be undertaken by the NP applicant as part of the supervised clinical practice
A copy of the learning plan and goals

Once all information is submitted, you will be advised in writing if the placement has been approved, after which time you may begin the placement. While there is no specified hours requirement, the supervised clinical practice experience must provide opportunities for learning, observation, demonstration and application of the NP's nursing knowledge, skill and judgement. Upon completion of the required education or training, CNO must receive official confirmation of completion of your supervised clinical practice. This may be demonstrated through the following:

For an NP supervised clinical practice completed through a nursing school, your educational institution must submit documentation (such as a transcript and Verification of Course Completion and Transcript Request Form) directly to CNO.
For an NP supervised clinical practice with a CNO approved NP supervisor, the proposed NP supervisor or organization must submit confirmation of completion directly to CNO. This can include a letter confirming completion of the practice experience along with the supervisor’s assessment of how the applicant demonstrated the NP competencies and standards, and the proposed learning plan outcomes.

If you are interested in completing an NP supervised clinical practice with an organization, please contact CNO in writing and we will advise you of required next steps. The organization and supervisor must be approved by CNO prior to starting the NP supervised clinical practice.