Practical Nurse Program for Internationally Educated Nurses (PN-IEN)
In 2006 NorQuest College successfully delivered The Practical Nurse for Internationally Educated Nurses (PNIEN) pilot project, which ran for 10 months, from February 6 to December 22, 2006. This project began with a development phase that included curriculum development, and establishing an interdepartmental relationship in order to develop English as a Second Language (ESL) curriculum rooted with nursing content. The development of a program that credits internationally educated nurses with their previous educational experience and promotes entry into the Canadian workforce, along with efforts to facilitate articulation agreements with other post-secondary institutions were also objectives set out in the development phase.
A delivery phase was also part of this project, and the objectives centred on the pilot of the ESL Bridging course, increasing student success in the Practical Nurse component of their studies at NorQuest College, thereby decreasing attrition within the program as well as increasing the employment retention rates of graduated individuals. Follow-up phases were allocated to occur throughout the course and six months post-graduation.
Project Activities
Within the development phase, many project activities were put forward. A needs analysis was completed, and marketing, learner identification and recruitment of applicants took place. The ESL Enrichment for required Practical Nurses courses was adapted and expanded where appropriate, with new nursing-specific ESL curriculum developed as necessary. As part of the intake process, applicants received a Canadian Language Benchmarks (CLB) PT assessment, nursing Prior Learning Assessment and Recognition (PLAR), and, for successful applicants, an individual learning plan was established. The final activity proposed in the development phase was to arrange meetings with MacEwan College to discuss the potential for articulation agreements or other points of collaboration. Although meetings were not able to be formulated with MacEwan College, communication and collaboration has taken place with other institutions. An exchange of curricula took place between NorQuest College and Halifax Immigration Learning Services. Discussions have taken place between NorQuest College and NAIT about offering occupational language for health care programs offered by NAIT. Some discussions have taken place with Mount Royal College primarily to learn about the Mt Royals’ development of the PLAR and assessment for internationally-educated nurses.
The delivery phase activities included the delivery of the ESL Bridge to Practical Nurse integrated with a Practical Nurse challenge course, the Practical Nurse required courses with ESL support, pre-practicum workshops, and nursing practicums. The administration of CELBAN listening/speaking took place at the end of the program. Dissemination of information occurred through updates provided at advisory committee meetings (BSCOC and LARCC) and presentations given at an Alberta Teachers of English as a Second Language (ATESL) meeting, an Alberta Colleges & Institutes Faculties Association (ACIFA) a Canadian Association of Practical Nurse Educators (CAPNE) conference, and the ELT 2006 conference in Ottawa.
Tracking of student employment success also took place at the end of the program, six months after graduation. The results of the employer surveys are still pending, and results will be forwarded upon return and tabulation of the surveys.
Outputs and Outcomes
Outputs
The primary output of the development phase of this project has been a nursing-specific curriculum. As a further output, this curriculum has since been shared with Halifax Immigration Learning Services. The output of the delivery phase of the program is best viewed from the perspective of the students involved. As a result of the PNIEN program, 16 qualified and capable practical nurses have graduated. Furthermore, these individuals are fully ready to enter the Canadian nursing workforce, having 100% successfully passed the national exam and thereby fully meeting the practical nurse licensing requirements.
Outcomes
This section will focus primarily on the individual participant outcomes. As a result of the ESL training received in the program, all of the students improved their language skills. A full table comparing the scores, from entry to completion, is provided in (see Summary of Program Outcomes). As a result of the nursing portion of the program, 16 students successfully completed the required nursing courses and practicum, resulting in graduation from the Practical Nurse program.
Further post-training results can be observed as a combined result of the ESL and nursing components, in that 100% of the students successfully passed the CPNRE. Further success stories arise in the fact that 100% of those desiring to work as LPN’s have procured employment. Furthermore, two students have continued on to pursue studies in an RN transfer program.
Aside from the successes of the students, other outcomes have come forth as a result of this pilot project. Partnerships have been initiated with Halifax Immigration Learning Services. Discussions have taken place with NAIT and Mount Royal College. On the healthcare facility end, a partnership with the Good Samaritan Society has been initiated. Feedback received as a result of this project has allowed for the continued refinement of the curriculum, to continue to improve the level and extent to which student needs can be met.
Offshoots
Some exciting offshoot opportunities have arisen out of the PNIEN project. One of the opportunities has been to continue to expand and refine the ESL curriculum as best practices have emerged through the running of this pilot, and the student feedback that resulted.
Moreover, an offshoot opportunity has arisen to provide a similar curriculum for other healthcare professionals. NorQuest College ESL programs enroll students from all over the world, who come with backgrounds from a wide variety of professions. Amongst the healthcare professionals, nurses are only one group. Individuals from other healthcare professions, such as dentists, physical therapists or radiologists, would require similar basic language needs as a nurse. While the specific content would of course vary, there are some similarities amongst all health professions, such as baseline medical terminology, the grammar involved for charting, intercultural communication needs and the language skills involved in communication tasks in the workplace.
Summary Statistical Report
Intake and Screening
The PNIEN program targeted 16 individuals. Due to the large number of presentations and information sessions that were given, it is not possible to estimate the total number of students who attended these sessions. Although there was a lot of interest in this program, 40 applicants were appropriate to be interviewed. Of these 40, nineteen students were registered in the program. Some individuals were not accepted as they did not meet the language requirements, while others removed themselves from the application process due to the financial implications of the program.
Summary of Program Outcomes
| Description | Number | Percentage |
| Total Participants | 17* | 100% |
| Those who completed the program | 16 | 94% |
| Those who did not complete the program | 1 | 6% |
| Those who were placed in work experience | 16 | 100% |
| Those who met the stated language outcome | 16 | 100% |
| Participants who completed the program and: Found employment in their field |
16 | 100% |
| *Two other participants withdrew during the first 28 days for personal reasons | ||
| Name | Country of Origin | CLB 1 (CLB~PT) (entry) |
CLB 2 (CLBA) (midway) |
CELBAN | |||
| L | R | W | S | ||||
| Mike | China | 6+ | 7 | 9 | 9 | 6 | 8 |
| X-ray | China | 7+ | W/D | ||||
| Yankee | China | 6 | 5+ | 10 | 8 | 6 | 8 |
| Charlie | Congo | 8-* | N/A | ||||
| Zebra | Congo | 7 | 8 | W/D | |||
| Foxtrot | India | 6+ | 6+ | 9 | 8 | 6 | 8 |
| Romeo | India | 6- | 5+ | 7 | 8 | 7 | 7 |
| Gulf | Japan | 6+ | 7 | 9 | 9 | 7 | 8 |
| Lima | Moldova | 4 | 5+ | 6 | 7 | 6 | 8 |
| Hotel | Phiippines | 7+ | 7+ | 9 | 8 | 7 | 8 |
| Bravo | Russia | 7- | 7- | 9 | 8 | 7 | 7 |
| Echo | Russia | 7 | 6+ | 7 | 7 | 6 | 7 |
| Kilo | Ukraine | 8* | N/A | ||||
| November | Ukraine | 7- | 7 | 9 | 8 | 7 | 8 |
| Oscar | Ukraine | 7 | 7 | 9 | 10 | 8 | 7 |
| Delta | Vietnam | 7 | 5 | 7 | 9 | 6 | 7 |
| Tango | Vietnam | 7 | 7 | 9 | 9 | 7 | 7 |
| Juliet | Yugoslavia | 8* | N/A | ||||
| Sierra | Yugoslavia | 7- | W/D | ||||
| *Those students who scored CLB 8 on their initial test were not required to test further as this CLB score is the entry requirement for the PN program at NorQuest College. | |||||||
Lessons Learned and Recommendations for Future Projects
The main lesson learned centers on the structure of the program, and the need to separate the language and PN challenge portions. The recommendation for future programs is that students complete their ESL portion prior to initiating any of the nursing components. It is still important that the ESL portion continues to reflect the language needs of the nursing specific content, but it is recommended that they are not placed in a situation which tests their nursing knowledge until the ESL support of this knowledge has been fully completed.
Another lesson learned has been in regards to the time needed to complete the required nursing courses. It is recommended that students need more than just a simple review of skills they have already learned in their home country; time must also be granted to allow for the situations in which the skill the nurses learned in their home country is not applicable to the Canadian context, and they must in fact ‘re-learn’ the skill.
Although it’s difficult to find the balance between setting an entry-level CLB requirement which allows for a sufficient number of students to be applicable for enrollment and a CLB level which provides a feasible baseline from which students to be able to improve, it is important to, first of all, establish a definitive score, and secondly adhere to that entry requirement. While it may seem like students of a lower level CLB may have a lot of potential for improvement, they have invested largely in the program, and may indeed have been inadvertently set up for a high level of anxiety and potential failure. Although it may seem a shame to turn these students away, they are actually better served by continuing with regular ESL programs until they have achieved the necessary entry requirements.
While it’s easy to focus on lessons learned through challenges, it is equally important to give attention to the lessons learned through the successes. The greatest highlight from this area comes from the fact that we have learned that a program tailored to the ESL, intercultural and nursing needs of internationally educated nurses can indeed produce qualified, competent individuals who are truly ready to enter the Canadian workforce. With extra focus on areas such as the language required for the workforce, as well as for their nursing and national exams, internationally educated individuals can succeed in a field where they often have previously struggled.