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Internationally Educated Nurses Competency Assessment Program (IENCAP)



The Internationally Educated Nurses Competency Assessment Program (IENCAP) is a standardized examination that tests the knowledge, skill and judgement of internationally educated nurses (IENs) seeking nursing registration in Ontario. In addition to nursing skills, the IENCAP will assess examinees’ language proficiency and comprehension, performance in client interactions, ethics, and professionalism. The program was developed by Touchstone Institute in collaboration with the College of Nurses of Ontario (CNO).
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Exam registration is currently suspended. Referrals will be contacted directly when registration resumes. Examinees who are currently registered for an exam will be contacted directly and provided with information about their rescheduled exam date.

Touchstone Institute will refer to all individuals challenging an exam as examinees. In some virtual experiences, the term candidate may be used interchangeably with examinee.


Preparation courses for the IENCAP are available through HealthForceOntario and CARE Centre for Internationally Educated Nurses.

Please Note: These are the only organizations that Touchstone Institute works with in regards to preparation courses. Touchstone Institute does not endorse, and is not associated with any other organizations that offer preparation courses for assessments.

Future Exam Dates

Future exam dates will be scheduled when it is deemed safe to do so, and those dates will be posted here when they are confirmed.






Registration for the IENCAP is available only to examinees who have received the following:

  • Referral from the CNO
  • Email confirmation from Touchstone Institute

For instructions on registering for the assessment, read the Application Portal User Guide.

For more information on IENCAP eligibility, please contact the College of Nurses of Ontario.

Before registering for a Touchstone Institute Exam examinees should ensure understanding of how the exam results contribute in the pathway towards licensure. If unsure, please contact the profession’s regulatory authority.

Request for Letter of Participation

Examinees may request a Letter of Participation to support visa travel requirements only after they have registered for an exam date. Letters cannot be issued without an exam date listed on them. Contact us here  to request a letter. participants should include their full name and CNO number in the request.


Fees & Payment

The IENCAP fee is CAN $1,500 and payable by Visa or MasterCard only. Cash, cheques or debit payments cannot be accepted. Registration is not complete without payment.

Cancellations & Refunds

Touchstone Institute accommodates a high volume of examinees and enforces a strict cancellation policy to ensure fairness. Please refer to the exam cancellation policy here.

Exam cancellation fee: CAD $600

Deadline for refund (minus administrative fee): 30 days before the examination


If there is a need to cancel your exam, it must be done through the Application Portal.

Instructions on how to cancel an exam can be found in the Portal User Guide.


What To Expect on Exam Days

Exam Days

What to bring to the exam:

Examinees may dress in nursing attire, but will not be scored on their clothing

Items not allowed in the exam:

Examinees should leave personal belongings at home, if possible, as many items are not permitted during the exam and storage space is limited. The following items are not allowed during the exam:

Any electronic device, including cell phones, smart watches and fitness trackers

Pens, pencils, pen lights

Paper, books, notebooks

Bags, luggage

Please note: All personal belongings will be collected at registration and stored until after the examination. Examinees are encouraged to bring as few personal belongings as possible. Once signed in, examinees will not be permitted to leave the examination area until all exam materials have been returned.

On the exam day, before starting the exam:


  • If an examinee is unwell or have extenuating circumstances which may negatively impact their assessment performance, they have the option to withdraw from the exam before it begins. Touchstone Institute will work with you to schedule an alternate date(s) for assessment.
  • If they choose to start the examination and request to leave before completing the entire examination, a staff member will document the reason for non-completion. This information will be forwarded to the CNO.

Breach of Examination Content and Process:

On exam days, examinees will be required to sign a document attesting that they will not disseminate or reveal to others any content of the IENCAP. Breaches include comparing client responses with colleagues, sharing exam content with future examinees and posting case information or exam questions online. Any breach in exam content or process may lead to disciplinary and legal measures, including invalidating exam results.

Additional Resources


Results from the IENCAP take up to eight weeks to process and are sent directly to the CNO. The CNO will communicate the results directly to examinee.


Exam Format

Please note: All of assessments are designed to standardize as many exam elements as possible. Depending on examinee registration numbers and facility parameters, exam format may vary from the information provided on the website. Information regarding specific exam dates will be provided with exam invitations. Touchstone Institute is committed to ensuring that all examinees are given a fair and valid assessment experience.

General Format

General Exam Format

No external contact is permitted during the exam.

The IENCAP consists of two sections:

  1. A virtual Multiple Choice Question (MCQ) examination – up to 85 questions (up to 2 hours and 15 minutes of writing time)
  2. An Objective Structured Clinical Examination (OSCE) – up to 12 stations (13 minutes each)

The IENCAP may include clinical content from the following areas:

  • Ambulatory care
  • Community/public health
  • Complex continuing care
  • Emergency care
  • Geriatrics
  • Intensive/critical care
  • Medical
  • Mental health
  • Obstetrics
  • Palliative care
  • Pediatric and adolescent health
  • Rehabilitation
  • Surgical

The blueprint for the IENCAP is based on the 2014 National Competencies in the context of Entry-Level Registered Nurse Practice.

Part 1: MCQ Exam

Part 1: Written multiple choice (MCQ) exam (up to 2 hours and 15 minutes)

The virtual MCQ exam consists of up to 85 questions. Examinees are required to choose the correct or best answer from a list of three or four responses. The MCQ exam assesses the following professional competencies:

Domain: Professional Responsibility and Accountability

Demonstrates an understanding of professional conduct in accordance with the College’s standards for nursing practice and ethics and that the primary duty is to the client to ensure safe, competent, ethical nursing care.

Domain: Service to the Public

Demonstrates an understanding of the concept of public protection and the duty to provide and improve health care services in collaboration with clients and other members of the interprofessional health care team, stakeholders and policy makers.

Domain: Self-Regulation

Demonstrates an understanding of professional self-regulation by advocating in the public interest, developing and enhancing one’s own competence and ensuring safe practice.

Part 2: OCSE Exam

Part 2: Objective structured clinical examination (OSCE)

Examinees complete up to 12 clinical encounter stations where they demonstrate their skills and competencies by interacting with a standardized client. At the start of each station, there will be instructions posted outside the exam room door that introduce the presenting clinical problem and state the task(s) the examinees need to perform.

The OSCE stations for this exam represent common workplace examples of the content areas. Examinees should manage each presenting case as they would in a real life practice setting. There are no hidden surprises or tricks.

Domain: Knowledge-Based Practice

This competency category has two sections: Specialized Body of Knowledge and Competent Application of Knowledge.

  1. Specialized body of knowledge: Draws on diverse sources of knowledge and ways of knowing, including the integration of nursing knowledge from the sciences, humanities, research, ethics, spirituality, relational practice, critical inquiry and primary health care principles.
  2. Competent application of knowledge: Demonstrates competency in the provision of nursing care. The competency statements in this section apply to the four areas of nursing care: Assessment, Planning, Implementation of Care and Evaluation. The provision of nursing care is an iterative process of critical inquiry and is not linear in nature.

RN Competency Category Sub-domains:

  • Comprehensive assessment
  • Health care planning
  • Provision of nursing care
  • Evaluation of care
  • Collaboration

Domain: Ethical Practice

Demonstrates competency in professional judgment and practice decisions by applying the ethical values and responsibilities in the College’s standards for ethics. The registered nurse also engages in critical inquiry to inform clinical decision-making and establishes therapeutic, caring and culturally safe relationships with clients and the interprofessional health care team.

The OSCE will assess an examinee’s:

  • Knowledge integration
  • Clinical skills
  • Behaviour
  • Attitude
  • Values


Exam Setup

Please note: Touchstone Institute reserves the right to make any necessary changes at any time without advance notice.

Two minutes of reading time

On the wall outside each clinical station there is a written statement (examinee instructions) that may include the following information:

  • Client’s name
  • Client’s age
  • Location of where the scenario is taking place (i.e., office, clinic, emergency room)
  • Task you are being asked to perform (i.e., physical examination, history taking, etc.)

Examinees will have two minutes to read the instructions outside the stations and make notes in their booklet (provided). An announcement will be made to let examinees know when they can enter the station. The examinee instructions will also be available in the exam room.

Inside the assessment room you will find the following:

  • Blood pressure cuff
  • Hand sanitizer
  • Examiner
  • Other station props related to the station scenario for examinee use or comment
  • Standardized client

*A standardized client is an individual trained to replicate a client’s signs and symptoms in a reliable and consistent manner. Treat them as you would a real client in a real clinical environment.

Seven minutes of total interaction time with the standardized client.

After the starting announcement, examinees will have seven minutes to interact with the standardized client and complete the required task(s) listed on the examinee instructions.

During the client encounter, examinees may be assessed on the following:

  • Health history and data collection
  • Physical assessment
  • Implementation of care strategies
  • Responsibility and integrity
  • Communication
  • Collaboration with the client

A standardized client is an individual trained to replicate a client’s signs and symptoms in a reliable and consistent manner. Treat them as you would a real client in a real clinical environment.

Examinees are required to explain to the station examiner exactly what they are doing during the assessment of the client. Remain focused and don’t forget that the examiner will be scoring your clinical skills and process. Successful examinees will be able to demonstrate their clinical ability with the client in a natural, focused, professional manner.

Examiners may move around the room to get the best view while you demonstrate your skills. Examiners may also provide information to examinees such as blood pressure results or vital signs if they are directed to do so on their scoring sheet and only after the examinee has initiated the examination maneuver.

At the six-minute mark, examinees will hear an announcement indicating that they have one minute remaining with the standardized client. This is a good time to provide a summary of the points covered with the client.

Four minutes

The client encounter is followed by a structured oral interview during which the examiner may ask up to four questions about the presenting case. During this time, the standardized client will no longer engage with the examinee.

During the examiner oral questions, examinees will be assessed on the following:

  • Analysis and interpretation of findings
  • Nursing care plan development
  • Prioritization
  • Evaluation and monitoring of care
  • Collaboration with the health care team
  • Ethical safety/advocacy
  • Legal obligations

Exit and proceed to the next station.

An announcement will be made to indicate when time is up. Examinees will be asked to leave the station immediately, move to the next station and begin reading the examinee instructions. Examinees are not allowed to enter or leave a station before they are told to do so.

Visualize the Assessment

People looking at screens showing camera footage

Voice announcements and video monitoring from a central location 

A person in scrubs talking to a patient

A standardized client interacts with an examinee

A person in scrubs talking to a patient

Subject matter experts score performance on tablets


Touchstone Institute has collaborated with the following organizations to develop and administer this assessment: