Nurses unions applaud changes to language proficiency tests, but critics say more needs to be done

Nurses in Manitoba are applauding benchmark changes to language proficiency tests, but critics say they are still problematic in a number of ways.

“I think it’s incredibly positive. We need to see how many nurses it affects but I think it’s going to have a big effect on the number of nurses who are passing the English proficiency and [being] registered,” Manitoba Nurses Union president Darlene Jackson said.

The changes apply to nurses registering in the College of Licensed Practical Nurses of Manitoba, College of Registered Nurses of Manitoba, or College of Registered Psychiatric Nurses of Manitoba.

Earlier this month, a number of nurses spoke out about the tests and scores — designed to evaluate English language proficiency in listening, writing, reading and speaking — saying they have failed their tests multiple times despite being born in Manitoba and fluent in English.

Although the tests are designed to test internationally educated nurses hoping to work in Canada, they are also required for Canadian-born nurses who haven’t completed the registration process within two years of graduating.

The tests use an outdated style of formal English rather than a contemporary style, critics say, adding the obstacle is driving nurses away when there is a severe shortage in the health-care system.

“For individuals that were raised in Canada and [for whom] English is their first language and don’t pass that test, they are very frustrated,” Jackson said. “For many of our younger people, they they don’t speak that way anymore and they don’t interpret the same way.”

A woman speaks at a podium that says, 'fix health care' as a group of people surround her.
Tamra Keeper spoke to reporters earlier this month about the problems with the language proficiency test. (Ian Froese/CBC)

On Monday, the College of Registered Nurses of Manitoba (CRNM) issued a news release announcing lower benchmark scores in part of three tests used across the country.

The listening component is reduced by 0.5 in the International English Language Testing System and by a full point in the Canadian English Language Benchmark Assessment for Nurses and the Test d’evaluation de français (for those in Quebec).

The IELTS exam’s benchmark in writing is also reduced by 0.5. No other changes have been made in any other component for that test or the CELBAN or TEF.

The process for the changes was led by a language assessment expert in consultation with regulatory bodies across the country in all three nursing professions — practical, registered and psychiatric, Martin Lussier, spokesperson for the College of Registered Nurses, said in an email to CBC News.

The updated language proficiency benchmarks for registration in nursing professions in Canada. Red numbers indicate the previous benchmark. (College of Registered Nurses of Manitoba)

“We are confident these updates are scientifically defensible and better aligned with language demands required for safe, ethical and effective nursing practice at the entry level” and help streamline the application process, he added.

There have also been complaints the tests are designed from a colonial perspective, which immediately puts Indigenous nurses at a disadvantage.

“It is very specific to a certain group of individuals who have been educated in a certain way, so for the general population, I’m not sure it’s representative,” Jackson said.

Asked about the idea of changing the test entirely, rather than lowering the benchmarks, Jackson said “that’s something that the college will ultimately make a decision on.”

For now, she wants to see how the changes play out.

“Having that mark decreased is, I think, going to have quite a good impact on nurses that have been having difficulty but still ensure that our nurses are competent and proficient in English — and that’s really important, the balance between those two,” she said.

“If it doesn’t, then we may need to be talking about looking at a different tool or looking at a different exam. But I think it’s a very positive move by the college to have done this.”

Nursing grad Tamra Keeper, from Tataskweyak Cree Nation, narrowly failed the test five times but her score under the new benchmarks would be a pass.

“I have reached out to the college to confirm this will meet the English proficiency policy of my RN application, so to me I feel like this is a step in the right direction,” she said.

“I am hopeful, I’m just waiting. Sometimes I think about it and smile but at the same time I try to be grounded.”

However, Keeper says the bias in some of the language in the tests remains a problem.

“In order to address the racism in the health-care system, I feel that we need to start at the roots and in the language,” she said.

Lussier says the College of Registered Nurses of Manitoba is continuing to review alternative measures of language proficiency “as part of our commitment to cultural sensitivity,” and expects that work to be complete in spring 2023.

In the meantime, Jackson encourages nursing hopefuls who failed the proficiency exam in the past to retake it as soon as possible “because we truly do need them in this system. We are floundering with the shortage of nurses.”

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