Category Archive Regulations in Nursing

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OSCE Now Delivered at Touchstone Institute (Information and FAQs)

Objective Structured Clinical Examination (OSCE) FAQs

What is IENCAP?

The IENCAP (IEN Competency Assessment Program) is a standardized examination designed to test the knowledge, skills and communication abilities of an Internationally Educated Registered Nurse. It consists of:

  • MCQ (Multiple Choice Questions): a short, written multiple-choice exam that tests general nursing knowledge.
  • OSCE (Objective Structures Clinical Examination): a series of mock client examinations in a clinical setting. Candidates taking part in this exercise will play the part of a registered nurse and apply their knowledge, skill and judgment in a number of client/caregiver situations.

For more details:

Why have I been asked to complete an OSCE?

After assessing your academic credentials the College has determined that your nursing program does not meet the program equivalency requirement for Ontario registration. You have been be asked to complete an Objective Structured Clinical Examination to demonstrate your nursing knowledge, skills and judgement before the College can proceed with your application.  Administered at the Touchstone Institute (formerly known as the Centre for the Evaluation of Health Professionals Educated Abroad) in Toronto, the OSCE gives applicants the opportunity to demonstrate their nursing knowledge, judgment and skills.

How does the OSCE work?

  1. Following application to register as an RN in Ontario, the College of Nurses (CNO) assesses the application to determine if the applicant’s educational background meets program requirements.
  2. If the applicant does not meet program requirements, the College will instruct the applicant to undergo an OSCE evaluation. Applicants who wish to appeal the College’s decision and continue with their applications without completing the OSCE will be referred to the College’s Registration Committee.
  3. Once the College has confirmed that you consent to an OSCE evaluation, Touchstone Institute will provide you with information about how to apply online and schedule your appointment.
  4. The OSCE and the MCQ are both completed on the same day at Touchstone Institute’s offices in Toronto.
  5. Candidates should expect to be at Touchstone Institute between five and six hours.


How many times can I do the OSCE?

One time only!
It is critical that you prepare in all 3 areas:

  • Knowledge
  • Skills
  • Communication

 How can CARE Centre help me prepare for the OSCE?


  • CARE Centre offers an Enhanced Communication Skills Workshop. Client interviews are an important part of the IENCAP (Competency Assessment Program)/OSCE. It is important to know what questions to ask; however, it is equally important to ask those questions in a clear and culturally appropriate manner. Members who have completed the OSCE all report the importance of good communication. Before confirming your OSCE appointment date consult with your case manager regarding your preparation.
  • Health Force Ontario offers frequent OSCE Preparation Sessions for Internationally Educated Nurses. These sessions include an overview of an OSCE, review of common questions and problems associated with an OSCE and practice with stems. Check the website for details regarding dates, locations, eligibility criteria and registration information:
  • Many Community Colleges will be offering OSCE preparation workshops. Check websites for details regarding dates, eligibility criteria and registration information.


What is the cost of the OSCE evaluation?

At this time, there is no charge to take the OSCE.

However, there is a $200 administrative fee that will be refunded after the College receives confirmation from Touchstone Institute of your completion of the OSCE evaluation.

Can I change my OSCE date?


Contact Touchstone Institute. All candidates changing their examination date will be charged an administration fee.  Please note all date change requests must be received at least 30 days prior to any scheduled exam. All exam date changes are contingent on availability.

What areas are assessed in the MCQ?

The IEN Objective Written Exam (MCQ) consists of questions based on five RN Entrance to Practice Competency Domains:

  • Professional Responsibility & Accountability
  • Specialized Body of Knowledge
  • Ethical Practice
  • Service to the Public
  • Professional Self-Regulation

What areas are assessed in the OSCE?

The blueprint for the OSCE is based on the National Competencies in the Context of Entry-Level Registered Nurse Practice. Skills and knowledge assessed may include:

  • History and Data Collection
  • Physical Examination
  • Communication Skills
  • Planning
  • Competent Professional Practice
  • Safe Practice
  • Ethical Practice
  • Collaboration
  • Evaluation

When will I get the results?

In approximately eight weeks, the College will receive the evaluation results. These results will determine whether the applicant has demonstrated entry-to-practice competencies in order to meet the program requirement.

What if I fail the OSCE?

Unsuccessful applicants with identified entry-to-practice competency gaps will be advised of additional training they will need to complete in order to meet the program requirement.

Who do I contact if I have any other questions about the OSCE?

Contact your CARE Centre case manager for questions regarding preparation for the OSCE.

For questions about the examination itself, including upcoming testing dates and directions to the testing centre, contact “Touchstone Institute (” at 416 924-8622 or email

Contact the College of Nurses of Ontario for questions about the registration process, including questions about how to appeal a decision requiring you to take the OSCE.


Lourdes VicenteByLourdes Vicente

NCLEX update from the College of Nurses of Ontario

Information for applicants who have already passed the NCLEX-RN exam: On September 18, 2014, the Council of the College of Nurses of Ontario passed a motion to accept successful NCLEX-RN exam writes from the beginning of 1982 to the end of 2014. If you are a current RN applicant who applied to the CNO before that date, and you can show the CNO you successfully wrote the NCLEX-RN within that timeframe, then you have met the examination requirement.

However, as for all RN candidates, their nursing program will be assessed to determine equivalency to a Canadian baccalaureate nursing program. Should the assessment indicate the applicant has unmet competencies they may be offered the opportunity to complete the IENCAP and may be required to take additional courses to meet the CNO “nursing education ” requirement.

If you are a CARE Centre member and have questions, contact your Case Manager. Review NCLEX information on the CNO website:

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CNO refers IEN applications to NNAS

The College of Nurses of Ontario (CNO) joined 22 nursing regulatory bodies across Canada to launch the National Nursing Assessment Service (NNAS). When NNAS’s Web portal went live on August 12, all internationally educated applicants to the CNO were directed to submit their applications and pay their initial assessment fees to NNAS within a secure online environment. A project nine years in the making, NNAS is the beginning of a national approach to the assessment of Registered Nurse and Registered Practical Nurse applicants who (a) completed their nursing education outside of Canada and (b) are not currently registered to practise as a nurse within Canada.

Benefits to applicants will include the ability to:

  • apply to multiple jurisdictions within Canada
  • send documents (e.g., education transcripts) to just one central location, regardless of how many jurisdictions an applicant applies to
  • track the status of their application online
  • access a toll-free customer care line with service in both English and French

Here are five key points to remember about NNAS and how it will work with the CNO to provide greater transparency and timeliness in its application processes:

  1. NNAS will not make decisions about an applicant’s eligibility for registration. The CNO and all other regulatory bodies involved with NNAS will continue to make the final decision on whether to accept or refuse an applicant’s request for registration.
  2. NNAS will conduct the initial review of an application. NNAS will function as the start of an applicant’s journey to registration by accepting the applicant’s initial application and assessing the documents (e.g., education transcripts, identity documents). NNAS will then create a report that the CNO will use along with other information to determine whether the applicant can proceed to the next steps in the registration process — steps the CNO will continue to administer. NNAS will apply only to those applicants who were educated outside of Canada and have never been registered as a nurse in Canada. Applicants who were educated at an approved nursing program in Canada or are currently registered as a nurse in another Canadian jurisdiction will continue to be assessed by the CNO under current registration processes.
  3. The registration requirements have not changed. Provincial legislation sets out the requirements that all applicants must meet before they can practise nursing in Ontario.
  4. NNAS only affects those who submit their applications after August 12. When NNAS is launched, all new applicants will be directed to the NNAS website to begin the application process. Applicants who apply to the CNO before August 12 will continue to be assessed by the College; they will not be asked to re-submit their applications to NNAS when its portal goes live.

The CNO is working to ensure all its systems and processes accommodate the transition to NNAS. This includes re-assessing application and registration fees to ensure the CNO continues its commitment to a revenue-neutral fee structure. The CNO is also communicating this change to the process through their website and direct communications with applicants. Further information about NNAS will be available at .

Lourdes VicenteByLourdes Vicente

Changes in the CNO Registration Regulations

General Recommendations:

  • If possible complete all registration requirements by December 31, 2012.
  • Register as soon as possible for the exam writings in 2013 (registration deadline is October 29, 2012 for RPNs, November 19, 2012 for RNs).
  • Contact your case manager regarding the implications of the regulation changes on your action plan. 
  • Check the CNO website frequently for updated information.
  • Contact the CNO to find out what the changes may mean to you, call the Customer Service Centre at 416 928-0900 (toll-free in Ontario 1 800 387-5526) or you can also submit questions via email.

Frequently Asked Questions

Question 1: I am out of safe practice for longer than 5yrs. I must take all elements. It states that the elements will meet CNO English fluency. Will this still be so if I complete elements late next year?

  • The rules governing the assessment and registration processes for all applicants will stay in effect until December 31, 2012.
  • Proposed changes to the fluency requirement have not yet been implemented. However  the proposed (but not yet implemented) Amendments to the Registration Regulation include:
    “All applicants will be required to demonstrate language proficiency in English or French through the successful completion of a Council approved examination (CELBAN, IELTS) and set score.”

Question 2: If I already have a safe practice date from CNO, will this be affected?

  • The rules governing the assessment and registration processes for all applicants will stay in effect until December 31, 2012. Applicants who are currently in the process of applying will continue to be assessed under the current regulation until that date.
  • Applicants who receive confirmation that they will not be able to complete all registration requirements by January 1, 2013, will be notified of any further steps they may have to take before completing the process.

Question 3: I am a RPN and want to apply for RN eligibility, how will the change affect me with regard to safe practice?

  • New regulations regarding 3 year safe practice  and 2 year application limitation go into effect January 1, 2013
  • If possible submit a completed RN application before December 31, 2012.

Question 4: What is this jurisprudence exam that is mentioned and how does this implicate my application?

  • The jurisprudence examination for RNs and RPNs  assesses  knowledge and understanding of the nursing profession in Ontario in terms of:
    • Nursing regulation
    • Scope of practice
    • Professional responsibility and accountability
    • Ethical practice
    • The nurse-client relationship
  • This examination becomes a registration requirement on January 1, 2013.
  • See CNO website for further exam details and information regarding cost.

Question 5: How will the CNO changes affect my current application and do I need to complete the registration process by December 31. 2012?

  • Complete registration before the end of 2012 if possible.
  • Applicants who are currently in the process of applying to join the College will continue to be assessed under the current regulation until December 31, 2012. Applicants who receive confirmation that they will not be able to complete all registration requirements by January 1, 2013, will be notified of any further steps they may have to take before completing the process.

Question 6: I have received the regulatory alert sent by CARE Centre; do I need to respond to CARE Centre or contact CNO to find out about what CNO is requesting of me for my current application?

  • General questions regarding the changes should be directed to the member’s CARE Centre case manager.
  • For more information on the regulatory changes and what they may mean to individuals, call the CNO Customer Service Centre at 416 928-0900 (toll-free in Ontario 1 800 387-5526). They can also submit questions via email.

Question 7: My application was received by CNO in 2010 and I received my letter of direction (LOD) in 2011. I am planning to sit the Exam (RN) in February, 2013. Will the application limitation period of 2 years affect me? If yes, does it mean come January, 2013 I will need to reapply?

  • Apply to write the February, 2013 RN exam on November 19, 2012.
  • Applicants who receive confirmation that they will not be able to complete all registration requirements by January 1, 2013, will be notified of any further steps they may have to take before completing the process.

Question 8:  I have a Competency Assessment Supplement (CAS) that I have not yet completed. Will the CNO accept it after the December 31, 2012 deadline?

  • Enroll in CARE Centre’s September Baccalaureate Equivalency Table/Competency Assessment Supplement workshop.
  • Submit the completed BET/CAS by December 31, 2012
  •  Applicants who receive confirmation that they will not be able to complete all registration requirements by January 1, 2013, will be notified of any further steps they may have to take before completing the process.