Is RP (Really) Good Enough for NCLEX?

There is no denying the fact that the leakage in the Philippine nursing licensure exam will make it more difficult for advocates to make their case for setting up an NCLEX-RN testing site in the Philippines. The ability to secure the integrity of the US nurse licensure exam is considered one of the more important criteria for selection in setting up an NCLEX-RN testing site.

In January 2005, the NCSBN set up three international pilot testing sites in Seoul, Hong Kong and London. Seven testing sites were added this year in Australia, India, Japan, Mexico, Canada, Germany and Taiwan, bypassing the Philippines for the second time.

The absurdity of the situation is hard to miss. Obviously, it would make more sense to set up an NCLEX testing site in what is undeniably the largest overseas source of RNs.

Filipino nurses have consistently made up the largest number of first time NCLEX-takers with a yearly average of 30 percent since 2003, according to a position paper prepared by the Philippine Nurses Association of America (PNAA). India comes as a far second at 5.8 percent (1,910) and Canada, at 5 percent (1,650).

If having the most number of test-takers is not reason enough to set up the test site in the Philippines, would the nurse exam leakage be reason enough not to set it up in the Philippines at all?

It may come as a surprise to the most jaded of Filipinos but cheating, exam leakages and other forms of dishonesty occur with as much frequency and magnitude outside the Philippines as well.

The so-called culture of cheating knows no geographic boundaries. It has reared its ugly head in health profession exams in the US and even in places chosen as NCLEX test sites.

Three years ago, the national board exams of three health professions no less were reportedly tainted with chat room leakages and exam question trading via email.

The Post-Gazette reported that more than 100 test questions from the standardized national exam administered by the Federation of State Boards of Physical Therapy were leaked into Internet chat rooms. Meanwhile, the National Association of Boards of Pharmacy caught a 200-question leakage by 15 foreign-trained pharmacists, including an Indian and a Korean. The National Board of Podiatric Medical Examiners and its testing agent, The Chauncey Group International, also had to deal with leakages involving hundreds of students from 4 of the 7 podiatry colleges in the US.

The American educational system is similarly infected with academic dishonesty. A March 2006 Newsweek International article cited a national study involving 50,000 college and 18,000 high school students conducted by the Center for Academic Integrity of Duke University where more than 70 percent admitted to cheating.

Newsweek also pointed to a British government-sponsored report on rampant cheating in its GCSE and A-level exams. The large-scale cheating led to call from the British Secretary of Education for total revamp of the coursework system.

In India, arguably the largest source of foreign-trained doctors in the US today, answers to Pre-Medical test questions were allegedly sold at $15,000 per student in 2004. Many of its highly competitive entrance exams have been sold to students at least once during the last 5 years, Newsweek said.

South Korea, one of the three NCLEX pilot test centers, reeled from what Newsweek mentioned as its biggest cheating scandal last year (the test site became operational in 2005), when the national college entrance exam was infiltrated by 20 cheating rings.

China, for its part, according to Newsweek has Web-based agencies in 19 provinces where students can hire look-alikes to take national tests for them.

That cheating has occurred in high-stakes testing in other countries, including international NCLEX test sites, simply proves that it is next to impossible to make a 100 percent guarantee against leakages and the like. What can be guaranteed though is the full support of concerned government agencies in enforcing measures that ensure the integrity of these exams.

If there is anything that this nurse leakage incident has demonstrated sufficiently, it is the commitment of the Philippine government and concerned organizations to protect the integrity of the nursing profession.

The Commission on Filipinos Overseas, the Philippine Nurses Association and the PNAA have joined forces to create a mechanism that will address this leakage incident and guard against similar incidents in the future. The Professional Regulatory Commission has already implicated two members of the Board of Nurses in this incident and is preparing administrative charges against them. The Philippine Congress, no less, is also looking into the issue.

True, the nurse exam leakage is a serious setback. Those who are culpable must be brought to justice and those who are in charge must make sure this does not happen again. The drive to set up an NCLEX test site in the Philippines will continue, nonetheless.

The real reason the Philippines has no NCLEX testing site might just have nothing to do with the much-ballyhooed selection criteria of the NCSBN. It might have something to do with the fact that easier access to the NCLEX would mean lesser CGFNS test takers because foreign nurses who pass the NCLEX need not be CGFNS-certified.

Neither the CGFNS nor the hundreds of review centers that thrive on Filipino nurses seeking employment in the US would be happy if there were no CGFNS test takers. It would certainly be better to bypass the Philippines as an NCLEX test site than to bypass CGFNS in favor of NCLEX. In that case, advocates may want to rethink their strategy and consider who would stand to lose (rather than who would stand to gain), if NCLEX tests were held in the Philippines.