The Nursing Council of New Zealand/ Te Kaunihera Tapuhi o Aotearoa has recently announced the introduction of a new model for registering nurses who have received their education outside Aotearoa New Zealand. Starting in 2024, the Council will no longer rely primarily on documentation, but will instead directly assess a nurse’s competence to practice safely. 

This will be along the lines of what is now used in Australia, the United Kingdom, and some other jurisdictions.  

An applicant’s knowledge, skills, and capabilities will be directly assessed over three main steps: 

1. An online exam, that is based on the State Final Examination that domestically-educated nurses must pass to be registered, that will assess an overseas nurse’s theoretical and conceptual nursing knowledge. 
2. An education module introducing nurses to the key features and nursing environment in Aotearoa New Zealand. It will include the importance for nursing in Te Tiriti, concepts like cultural safety, the health and disability system, and the culture and expectations of nursing practice. 
3. An Objective Structured Clinical Examination (OSCE), which will test a nurse’s clinical and professional skills in a simulated environment. 

A clear dedicated path will be delineated for those Internationally Qualified Nurses (IQNs) who wish to join the Register as Enrolled Nurses. 

Catherine Byrne, Chief Executive and Registrar of the Nursing Council, stated that they were confident this new model will preserve public safety and reflect modern good practice in regulation.  

Speaking on these changes, she said, “Requiring all nurses to complete an Education Module also helps ensure that from day one they understand the unique environment, culture, and expectations of nursing in Aotearoa New Zealand – including our specific approach to concepts such as cultural safety.” 

She also noted that this will reduce the compliance burden on international nurses who wish to practise in New Zealand. As their competence will now be directly assessed, the amount and type of other evidence required can be reduced. As a small example, instead of requiring a minimum number of recent practice hours, nurses will only be mandated to have practised for at least a year after gaining their initial qualification. 

What does this mean for current and new international applicants? 

The Council’s target date for implementing this new model is the beginning of 2024.  

Note that if you are an IQN who is currently applying, being assessed, or considering coming to practise in Aotearoa New Zealand, you will not have any immediate effect on your application. 

Over the next year, the Council will work with IQNs, employers, and other stakeholders to develop a fair transition process for any IQN who is still being assessed when the new model comes into effect. CAP providers will also be consulted, to ensure that nurses currently required to complete a CAP course are able to do so before the introduction of the new model. 

What does this mean for CAP? 

Once the new model is in place, nurses will no longer need to complete a Competence Assessment Programme (CAP) before joining the Register. All the positive elements of the CAP experience will still be maintained under the new model, and the Council is engaging with CAP providers to explore how this can be done. 

At present, Competence Assessment Programmes are also used by some nurses who have not practised in some time and want to return to work. The Council plans to work toward making sure that such return to practice programmes continue to be available for whoever needs them. 

Cost and delivery of the new model 

A fee structure has not yet been set. However, it is expected that the total cost for applicants will be less than the current cost of completing CAP programmes. 

The proposed exam will be delivered online and nurses will be able to sit it overseas. In the next step, the OSCE will be delivered in Aotearoa New Zealand and will be able to be completed in one day. The Council is considering adding a short pre-OSCE orientation to support and explain the process to applicants. 

Note: Recently, the Government has announced a financial support scheme for nurses who need to complete CAP programmes.  

Check this link to know more about this fund:  

What is an OSCE? 

OSCE stands for “Objective Structured Clinical Examination”. The OSCE tests practical skills through a series of simulated clinical settings (‘stations’). Applicants are individually assessed for their performance during a specific clinical scenario designed to test a particular skill area.  

Such assessments were initially developed in the 1970s and are now being used for assessing health professionals across the globe.  

How is the education module different to Competence Assessment Programmes? 

Presently, CAPs are not primarily intended as learning experiences. They are structured as programmes through which a nurse can demonstrate they are competent and safe to practise in Aotearoa New Zealand.  

In the new model, the initial exam will judge conceptual competence, after which clinical competence is assessed through the OSCE. The education module is planned to be designed to teach IQNs about what it means to be a nurse in Aotearoa New Zealand, and about how New Zealand’s context for health and practice is different from that in their native countries. 

This education module will not have a clinical placement component, and will take significantly less time than a CAP.  

At present, only some nurses have to complete CAPs. However, under the new model all IQNs will receive a common and consistent orientation to being a nurse in Aotearoa New Zealand, in addition to what may be provided by their employer. 

Will all nurses have to complete all steps of this model? 

This is yet to be finalised. The Council might decide to introduce alternative pathways to registration. As the programme is being developed, they are likely to explore options for nurses educated and registered in peer International Nurse Regulator Collaborative jurisdictions (Ireland, Singapore, the United Kingdom, and some states in Canada and the United States). There will also be pathways for nurses educated and registered in Pacific nations. 
 

In any case, all IQNs will be required to complete the education module, as this is not designed to assess competence but introduces the local nursing environment. 

Nurses registered in Australia will not be affected by the new model, but they will retain their right to registration under the Trans-Tasman Mutual Recognition Act 1997. 

The next 15 months will see the Council working with the sector, national and international experts, and contracted partners to develop detailed elements of the new model. All assessments will be fair, calibrated appropriately, and comprehensive, and the Council will make sure that the necessary delivery and assessment infrastructure is in place. This period of time will also allow for a transition process to be developed that smoothens the journey for international nurses, their employers, and the health and disability support system. 
 

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