Did you know that about 45% of nursing students that were trained in another country pass the NCLEX on the first try? Also, only about 27% of internationally trained nursing students who are repeating the NCLEX pass. That’s compared to about 88% of U.S. students passing the first time. And 44% of U.S. students that are repeating the NCLEX pass. So, why do international students have a harder time passing the NCLEX?
1) There is a language barrier
A person can speak very broken English, but understand everything they are reading in English. This is a huge advantage when taking the NCLEX. Your spoken English can be quite good, but your reading comprehension may be minimal or poor. Therefore, if your English is better with reading comprehension, you will do better on the NCLEX.
If English is not your first language, start reading books, articles, and blogs that are written in English. Make sure to understand what you are reading. Keep a dictionary close by to look up words you don’t know. The NCLEX test questions are written at the 10th grade high school level or a bit below. Since most people on average watch a few hours of video or TV every day, you could easily read instead. You have to consciously make that decision to sit down and read though. If you want to be a nurse, this is what you have to do. No one said it was easy.
2) Nursing is different in other countries
“We don’t do it that way in my country.”
“We would never say that in my country.”
“The nurses don’t do that in my country.”
“Only the doctors do that in my country.”
“In my country, we always just call the doctor when we don’t know what to do.”
I absolutely love that nursing is different in other countries. I have a friend from Vietnam that was a maternity nurse for 8 years there before coming to the U.S. permanently. She worked 12 hours a day, most of the week. She told me she didn’t use a stethoscope, but would do the sutures for the episiotomies! In North America, only the doctor can do the sutures!
If you are coming from another country, it is absolutely necessary to do a thorough review of the nursing content. Learn about what is in the nurse’s “Scope of Practice”. You can start reading here to learn about the “nursing scope of practice”.
3) There are cultural differences
There are two sections on the NCLEX test plan that appear to be more culturally based to focus on North America. Those sections are Psychosocial Integrity and Management of Care.
A big part of the Psychosocial Integrity section is how to talk to clients based on what their psychological problem is. This can be hard even for students who grew up in the U.S. or Canada!
Learn about Therapeutic Communication. When studying, don’t just depend on the review course you took. Get a good NCLEX content review book (like Saunders) and read about therapeutic communication. Understand what the techniques are and then go practice hundreds of questions to see how to apply it.
Management of Care section is another section that is typically more difficult for international students. Why is this? It has a lot of ethical and legal content that you have to know! Laws are different in other countries. There may be less confidentiality and less lawsuits in other countries. In North America, it is a very litigious environment. You have to be extremely safe with patients to never make a careless mistake.
Learn about the laws in North American and Canada in regard to medical malpractice. Once again, just get a good book to read about these things. You can use the Saunders book. She covers it all in a lot of detail.