Fact sheet: Transition to a new assessment model for internationally qualified nurses and midwives

Prior to the start of the National Registration and Accreditation Scheme in 2010, the assessment of IQNMs was undertaken by the state and territory boards. In 2010, Ahpra developed a national model for the assessment for IQNMs. Following a review of assessment processes, the NMBA developed an interim model of assessment for IQNMs which has been in place since 2014. The interim model was based on eight qualification assessment criteria and resulted in a more equitable and consistent assessment of IQNM applications.

The NMBA has moved to a permanent approach in the assessment of IQNMs. Changes under the new model include a reduction in the assessment criteria from eight to three, which took effect in January 2019.

This change streamlines the assessment process; however, the outcomes from assessments remain the same as under the previous eight criteria.

In March 2020, the NMBA transitioned to an outcomes-based assessment (OBA) for IQNMs who hold a qualification that is relevant but not substantially equivalent or based on similar competencies to an Australian approved qualification (and who demontrate they meet the mandatory registration standards). This replaced the need for new referrals to bridging programs.

The NMBA undertook an extensive research project to explore the factors and requirements to establish an OBA which made recommendations that:

• the overall assessment process includes both a cognitive and behavioural component
• the cognitive assessment must be passed before the behavioural component is attempted, and
• an orientation program is established to orientate nurses and midwives to working in the Australian healthcare context.

The new model of assessment includes:

• the online Self-check for all IQNMs
• an orientation program for all IQNMs who are advised to continue with the assessment process, and
• an OBA for some IQNMs.

Self-check

The assessment of qualifications continues to be against three criteria.

All IQNMs need to submit their qualification information at Self-check. IQNMs will then be advised of the steps (assessment stages) they must successfully complete before being eligible to apply for registration.

After Self-check, IQNMs who are assessed as holding a qualification that is substantially equivalent or based on similar competencies to an Australian approved qualification (and who can demonstrate they meet the mandatory registration standards), will be eligible to apply for registration following completion of Orientation Part 1. (See Orientation program below for more information). These IQNMs will progress in the process as Stream A candidates.

IQNMs who are assessed as holding a qualification that is relevant but not substantially equivalent or based on similar competencies to an Australian approved qualification (and who can demonstrate they meet the mandatory registration standards), will be required to successfully complete an outcomes-based assessment (OBA) prior to being eligible to apply for registration. These IQNMs will progress in the process as Stream B candidates.

 IQNMs that do not hold a relevant qualification (under section 53 of the National Law) or do not meet the required assessment criteria will need to upgrade their qualification in Australia before being eligible to apply for registration. Their qualification can be upgraded in Australia (through completion of an NMBA approved program of study) or any other country of choice providing the qualification meets the qualification assessment criteria. These IQNMs will be assigned to Stream C.

Orientation program

All IQNMs who are advised to proceed in the IQNM assessment process will need to complete the orientation program in order to be registered in Australia. Please see the Orientation Part 1 and Part 2 fact sheet for more information. There are two parts to the orientation program.

Yes, the Self-check provides advice for applicants from New Zealand, who are eligible under the Trans-Tasman Mutual Recognition Act.

Yes. All IQNM’s will need to provide evidence of meeting the NMBA mandatory registration standards.

There is no fee to use the Self-check.

After completing the Self-check, all IQNMs who are advised to proceed in the IQNM assessment process will need to pay a non-refundable assessment fee of $640 AUD. This fee contributes towards Ahpra’s costs in checking IQNM documentation provided, and for the IQNM to undertake their orientation.

IQNMs who are referred to the OBA will need to pay specific OBA fees which are outlined below. (See question 'How much are the fees for the OBA and where can I sit the exams?').

All IQNMs who are eligible for registration and meet the mandatory registration standards will need to pay a registration fee and application fee in order to be registered. The current application fee of $300 AUD and registration fee of $175 AUD continues to apply.

The OBA is a two-stage assessment process: a multiple-choice question exam (MCQ) and an objective structured clinical exam. IQNMs must pass the first stage before moving to the next stage.

Stage one is a cognitive assessment, which is a computer-based MCQ exam. IQNMs must pass the exam to move to part two of the OBA.

Stage two is a behavioural assessment in the form of an objective structured clinical examination (OSCE). The OSCE has been developed to assess that an IQNM demonstrates the knowledge, skills and competence of a graduate level Australian nurse or midwife.

The OBA is the assessment process for IQNMs who wish to register in Australia and who are assessed as holding relevant but not substantially equivalent qualifications (and who demonstrate they meet the mandatory registration standards).

IQNMs with a referral to the OBA will be able to begin the OBA process in March 2020.

IQNMs undertaking the OBA must pass each assessment stage before undertaking the next. The time taken to complete the OBA is dependent on how quickly the IQNM can progress through the assessments.

IQNMs who hold a current referral to a bridging program can contact Ahpra to request a referral to the OBA instead. IQNMs should contact the Registration Officer named in their referral letter.

IQNMs who have already started a bridging course should continue to complete the program.

Cost and locations for the MCQ exam

The MCQ exam is computer-based and is delivered at dedicated test centres. There will be separate exams for IQNMs seeking registration as a registered nurse, enrolled nurse or midwife:

• Registered nurses will sit the National Council Licensure Examination for Registered Nurses (NCLEX-RN). The National Council of State Boards of Nursing (NCSBN) develops and administers the NCLEX-RN through Pearson VUE test centres located in most countries.
• Midwives will sit an MCQ exam managed by the NMBA, which will be delivered through Aspeq test centres in most countries.
• Information for on the enrolled nurse MCQ exam will be published soon.

Note: IQNMs must be authorized by Ahpra to sit the MCQ exams.

Fees for the MCQ exams are set by the providers and paid directly to them. At the time of publishing, the following fees apply:

• For registered nurses, the NCLEX-RN registration fee is $200 USD, plus an additional international scheduling fee of $150 USD ($350 USD in total).
• For midwives, the fee is $165 NZD, plus a possible fee for overseas venues.
• Enrolled nurse exam fees will be published soon.

Cost and locations for the OSCE

IQNMs who have been referred to the OBA must pass the MCQ exam before they can attempt the OSCE.

The OSCE is managed by Ahpra and is delivered at the Adelaide Health Simulation in Adelaide, South Australia.

The fee for sitting the OSCE is $4,000 AUD. The OSCE fee replaces previous bridging program fees from private providers. This fee pays for Ahpra’s costs in running and maintaining the OSCE. Ahpra and the NMBA are funded only by fees, which must cover all costs of assessing IQNMs for registration in Australia.

No. OSCE preparatory courses are not provided by Adelaide Health Simulation, the NMBA or Ahpra.

Bridging programs are expected to continue into 2021 for IQNMs who hold a referral to bridging. A referral to bridging does not guarantee a place in a program.

• Visit the Internationally qualified nurses and midwives section of the NMBA website
• Visit the Registration standards section of the NMBA website
• Visit www.nursingmidwiferyboard.gov.au under Contact us to lodge an online enquiry form
• For registration enquiries: 1300 419 495 (in Australia) +61 3 9275 9009 (overseas callers)