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).
Please Note: These are the only organizations that Touchstone Institute works with in regards to preparation courses. Touchstone Institute does not endorse nor are we associated with any other organizations that offer preparation courses in regards to any of our assessments.
Future Exam Dates
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 you register for a Touchstone Institute Exam please ensure you understand how the exam results contribute in your pathway towards licensure. If unsure, please contact your 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. Please include your full name and CNO number.
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 our exam cancellation policy here.
Exam cancellation fee: CAD $600
Deadline for refund (minus administrative fee): 30 days before the examination
If you need to cancel your exam, it must be done through the Application Portal.
Instructions on how to cancel your exam can be found in the Portal User Guide.
What To Expect on Exam Day
What to bring to the exam:
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:
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 you have signed in, examinees will not be permitted to leave the examination area until all exam materials have been returned.
On the exam day, before you start the exam:
- If you are unwell or have extenuating circumstances which may negatively impact your assessment performance, you have the option to withdraw from the exam before it begins. Touchstone Institute will work with you to schedule an alternate date for assessment.
- If you choose to start the examination and request to leave before completing the entire examination, a staff member will document your reason for non-completion. This information will be forwarded to the CNO.
Breach of Examination Content and Process:
On exam day, 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 your 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 your results.
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.
All of our assessments are designed to standardize as many exam elements as possible. Depending on examinee registration numbers and facility parameters, exam format may vary in administration. Our commitment is to ensure that all examinees are given a fair and valid assessment experience.
General Exam Format
The IENCAP consists of two sections, which take place on the same day over approximately six hours.
No external contact is permitted during the exam.
- A tablet-based Multiple Choice Question (MCQ) examination – up to 97 questions (2.5 hours of writing time)
- An Objective Structured Clinical Examination (OSCE) – 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
- Intensive/critical care
- Mental health
- Palliative care
- Pediatric and adolescent health
The blueprint for the IENCAP is based on the National Competencies in the context of Entry-Level Registered Nurse Practice.
Part 1: MCQ Exam
Part 1: Written multiple choice (MCQ) exam (2.5 hours)
The tablet-based MCQ exam consists of up to 97 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.
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 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:
This competency category has two sections: Specialized Body of Knowledge and Competent Application of Knowledge.
- 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.
- 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
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
Please note: Touchstone Institute reserves the right to make any necessary changes at any time without advance notice.
Inside the assessment room you will find the following:
- Blood pressure cuff
- Hand sanitizer
- 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.
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.
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
- 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.
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
- 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.