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

See "Future Exam Dates" below.

Please note: Anyone wishing to take the in-person OSCE, Touchstone Institute has implemented a COVID-19 Vaccine Policy.

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In-person OSCE Location: 145 Wellington Street West, Toronto, M5J1H8

MCQ Location: Remote Virtual

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

The 2022 schedule is posted below.

Future exam dates will be posted here once they are confirmed. Registration begins at 10:00 am EST

Virtual MCQ & In-Person OSCE Options

Date chart

Virtual MCQ & Virtual OSCE Options will be posted when dates become available.



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 Virtual MCQ and In-person OSCE fee is CAN $1,500. The Virtual MCQ and Virtual OSCE fee is CAN $1750. Both are payable by Credit Card or Visa Debit through PayPal. Cash and cheques 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 a refund (minus an administrative fee): 30 days before the date of your first exam component.

If there is a need to cancel your exam, contact


Exam Format

All 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 71 questions (up to 110 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.

Virtual MCQ Exam

Virtual multiple-choice question (MCQ) exam (up to 110 minutes)

The virtual MCQ exam consists of up to 71 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.

In-Person OSCE Exam

In-Person OSCE: 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

Virtual OSCE Exam

Virtual OSCE Examination

Touchstone Institute is planning a limited number of Virtual OSCE examinations. Capacity will be limited. Dates will be posted when further information is available.  The cost for this examination will be CAN$ 1750 .

Virtual Examination Requirements

Virtual Examination Requirements

To participate in the Multiple Choice Question (MCQ) Examination and the Virtual OSCE, the following Technical Requirements need to be met:

Please review the following list of requirements below and ensure you meet these requirements in order to successfully participate in the online MCQ examination.

  • Access to a computer (desktop or laptop). This exam cannot be taken on a tablet or mobile device.  Dual monitor configurations are not permitted
  • A minimum screen resolution of 1024 x 768 is required; however, a screen resolution of 1920 x 1080 or higher is recommended
  • External or built-in webcam.  You must be able to move your webcam in order to show your surroundings
  • Wired Ethernet connection to ensure the best exam experience and to reduce the risk of interruption to your internet connection (click here for more information on connecting to the internet via Ethernet).  Ethernet cables at various lengths can be purchased through Amazon or other computer or electronic stores like BestBuy, the Source, etc.
  • In the absence of Ethernet connectivity, examinees need a strong and reliable high-speed internet connection of at least 10 Mbps upload and 20 Mbps download (please click here to conduct a speed test to confirm your connection speed).  Your exam experience will be dependent on your ability to maintain a strong Wi-Fi connection within your test environment.
  • If a wired Ethernet connection is not possible, the test space should be as close to your internet router as possible.
  • Devices that might interfere with internet speed/connection need to be turned off.  Live-streaming of movies or the playing of video games is discouraged.
  • Windows 8 or above or Mac OSX 10.13 or above (*click here for instructions on how to check your operating system)
  • The latest version of Google Chrome
  • Download ZOOM application to your computer (for virtual OSCE only)
  • A quiet, private space with a table and chair to ensure confidentiality of exam.  The area must be clear of writing utensils, electronics, notes, etc. No additional people can be in the room.

OSCE Examination Process

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.

For further information, see OSCE Orientation.

What To Expect on OSCE Exam Day

OSCE Exam Day

What to bring to the exam:

Copy of your exam invitation that was emailed to you, either a physical copy or on your phone.

One piece of valid photo identification. Acceptable pieces of photo identification include; a valid passport, a valid driver’s license, or Canadian citizenship or permanent resident card.

Covid-19 Vaccination Certificate

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, tablets, computers

Pens, pencils, paper

Books, notebooks

Personal bags, wallets, purses, keys

Food, drinks

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 has 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.

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:

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