Updating RPN exam

CNO and the British Columbia College of Nurses and Midwives (BCCNM) have developed a new entry-to-practice exam for Practical Nurses. We have partnered with the National Council of State Boards of Nursing (NCSBN) to develop the exam, known as the Regulatory Exam–Practical Nurse™ (REx-PN™). It launched on January 4, 2022.

The REx-PN tests Canadian PN entry-to-practice competencies. It’s based on current RPN practice, is focused on client safety, and ensures nurses who enter practice have the knowledge, skill and judgment needed at the beginning of their careers to practice safely.

Regulatory Exam - Practical Nurse

Timeline:

Our partners:

Health care continues to advance rapidly. As a result, the competencies nurses need to apply are constantly evolving. In addition, the large and growing populations in both Ontario and British Columbia are increasing the need for nurse resources.

Each year in Ontario and British Columbia, about 7,000 people apply to write the regulatory exam needed to practice as a Practical Nurse (PN). As two of the country’s largest regulators of PNs, CNO and BCCNM face similar challenges when assessing large numbers of applicants to ensure they are ready to practice safely. This is why Ontario and B.C. worked together to develop a new exam and related processes that will allow us to continue to test effectively this large number of applicants for competencies they need to practice safely.

After a thorough review of possible vendors to assist us with this work, CNO and BCCNM chose the National Council of State Boards of Nursing (NCSBN). NCSBN brings expertise in exam development, security, technology, research and administration in a way that most closely aligns with our current needs, our plans for future growth, and the potential enhancement in testing methodology and safety.

In addition, we worked with other Canadian regulators to create a national set of entry-to-practice competencies that RPNs. As part of this work, we got input from Canadian educators from French and English nursing programs, recent graduates, current RPNs and other stakeholders. This collaborative work will ensure that the content the new exam covers is reflected in what is being taught, and that academic institutions have the time they need to make any necessary changes to their curriculum (see PN Exam Transition Working Group for the latest updates)

Benefits of these changes include:

Staying current: We're always looking for ways to improve public safety, and routinely review the latest evidence to see where we can make improvements. This review also considers the current competencies needed by nurses today.
Improved security: Advancements in technology continue to make it easier to proactively monitor and rapidly respond to breaches in exam security.
No limit on writes: Writers of the former CPNRE exam were limited to three attempts to pass the exam. Because the REx-PN is a computerized adaptive test (CAT), there are no limits on the number of times a writer can attempt it. The system knows if a writer is retaking the exam and supplies them with a set of questions that is different from those the writer had in previous attempts.

Regardless of the number of attempts, the only way a person will successfully pass the REx-PN is if they are able to show they have the knowledge, skill and judgment to practice safely as an entry-level RPN.
Accessible: The REx-PN is available to write at any time in permanent and temporary centres of the exam provider, Pearson VUE. REx-PN writers will have to wait a minimum of 60 days between attempts, which is a maximum of six attempts per year.
Fast feedback: REx-PN exam writers usually receive their results within two business days of writing. If a writer is not successful on their exam, CNO will send them a Candidate’s Performance Report (CPR), which provides information about how they did in each section of the exam, and indicate whether they performed above, near or below the passing standard to help them prepare for a future exam write.
Availability of prep materials: A Practice Exam is available from the exam developer. It gives the "look and feel" of writing a CAT exam, which is the format of the REx-PN and one that some exam writers may not be familiar with. The Practice Exam is not intended to be a study guide or to determine readiness to write the REx-PN.

An RPN applicant's nursing education and the resources on this page should be enough to prepare the applicant to write the REx-PN. Third-party vendors may develop and offer REx-PN preparation courses, but it is important to be know that they do not have access to the REx-PN question bank. CNO is aware of some preparation courses being developed in English, but CNO cannot attest to their success in helping someone prepare to write the REx-PN. To date, we have not been made aware of any preparation courses being produced in French, although we continue to make inquiries.
Increased stakeholder involvement: Nurses in Canada form the committees working on the exam. French educators from Ontario are involved in the development and translation process, which is rigorous and evidence informed. We’ve solicited early feedback from educators of PN programs about the new exam, as well as the time they need to incorporate any revised competencies and exam format into a new curriculum. We continue to engage with other stakeholders.

Resources for Educators

The following resources show how we developed the REx-PN.

Practice Analysis

To start the process of creating a new exam, we first conducted a Practice Analysis in early 2019, which included participants from both B.C. and Ontario. We assembled a panel of subject matter experts to help create a list of RPN activities, which we then incorporated into a survey sent to new RPNs. We analyzed the survey data. The recently revised national entry-level/entry-to-practice competencies were also mapped to the Practice Analysis to ensure the exam includes competencies essential for safe nursing practice.

Because the Canadian health care industry is evolving rapidly, CNO and BCCNM will conduct Practice Analysis studies every five years.

Download the REx-PN™ Practice Analysis

Preparing to write the REx-PN

REx-PN Fact Sheet 1: General Information
REx-PN Fact Sheet 2: Available Resources
REx-PN Fact Sheet 3: Writing the REx-PN exam
Test Plan:
The REx-PN does not test everything an RPN needs to know throughout their career. It tests the competencies — knowledge, skill and judgment — nurses are expected to have within the first year of practice to keep patients safe. Applicants can use the Test Plan to help them prepare to write the REx-PN. The Test Plan details the content areas the REx-PN tests and describes how the exam is structured, including its length and how it is scored. Educators can also use the Test Plan to guide them in writing REx-PN-type questions, so they can help students prepare for the exam.

The Test Plan also provides direction to those developing exam questions.

Questions for the REx-PN are developed by Canadian nurses.
Mapping document To show how the REx-PN will test specific RPN competencies, we've mapped the competencies to the content areas of the Test Plan.
Video: Computerized Adaptive Testing (CAT)
Practice Exam: A set of two REx-PN practice exams is available from the exam developer. They give the look and feel of a Computerized Adaptive Test (CAT) — the format of the actual REx-PN exam applicants will take on their test day.

Field Testing with students

To ensure that the questions on the REx-PN are a fair test of the knowledge, skill and judgment that RPNs entering practice nee, we field-tested questions with final-year PN students. We are grateful to the hundreds of students across Ontario and B.C. who gave their time to this testing. By participating, they show leadership and accountability to their future profession.

A collaborative process

We are committed to engaging with stakeholders throughout the exam development process and after its implementation. Opportunities to contribute and be involved, such as item writing and item review panels, are posted on the CNO and BCCNM websites. We will continue to offer workshops for educators, as well as information sessions.

If you have questions about the REx-PN, contact us at RExPN@cnomail.org.