Essential Requirements for Study in Baccalaureate Nursing Programs in Ontario

Created by the Council of Ontario University Programs in Nursing (COUPN) January 2019

This section provides information for applicants to Ontario baccalaureate nursing programs, students, faculty, staff, accessibility service providers, health professionals, and the public about the essential requirements for successful completion of these programs.

Purpose

• provide information to prospective baccalaureate nursing students so they can make an informed choice regarding applying to a program

• assist prospective and current students in deciding if they should register with student accessibility services

• assist students, student accessibility advisors, faculty, staff and health professionals in developing reasonable accommodations such that students may meet the essential requirements

• help ensure the safety of students during the education program

• help ensure the safety of patients/clients during student clinical encounters

Context for Learning in a Baccalaureate Nursing Program

Ontario baccalaureate programs in nursing have a responsibility to provide their enrolled students with opportunities to develop the qualifications (academic knowledge, professional behaviours, attitudes and clinical skills) to enter the profession of Registered Nursing in Ontario. Learning moves from simple to complex in order to prepare graduates to meet entry-to-practice competencies set by the College of Nurses of Ontario (CNO)¹. Students learn in the academic classroom and simulation lab, and also engage with patients/clients in a range of settings from hospital and long-term care to home and community. Patients/clients may be individuals in isolation or with their families; clients may also be a community or a population.

The description of the essential requirements below is not intended to exclude individuals who may require reasonable accommodation to achieve competency development. It is advisable to discuss such accommodations and/or learning supports with the university’s student accessibility services during the pre-admission or admission phase.

Requests for accommodation and/or learning supports are considered on a case-by-case basis, according to provincial laws and the educational institutions’ applicable policies, regulations, and procedures. 

An offer of admission to a nursing program is not evidence that the nursing program has independently verified an applicant’s ability to meet the essential requirements in the domains described below. In addition to obtaining a Canadian nursing baccalaureate degree or equivalent, graduates must meet the additional seven requirements set by the CNO in order to become registered and practice as a Registered Nurse in Ontario.²

Description of the Essential Requirements for Students in Ontario Baccalaureate Programs in Nursing

Cognition

Students must be able to acquire and retain new information from various sources. Examples include reading and comprehending a range of written documents, including anatomical diagrams, digital displays, medication labels, textbooks, articles, and columns of numbers such as those recorded on flow charts. Students must be able to sustain prolonged attention, concentration and focus on various academic activities, as well as in stressful and distracting practice environments. They must be able to retain information and commit it to memory, and apply and transfer information from one situation to another. Other cognitive skills that are required include: telling time; counting rates such as a pulse; accurately adding, subtracting, multiplying and dividing; computing fractions; using a calculator; writing numbers in records; identifying and differentiating sounds related to heart, lung or other body systems; and recognizing abnormal odours.

Information gathering

Students must be able to participate in learning situations and client interactions for the purposes of gathering and recording information. This information may be gathered in a number of different ways, including but not limited to observing (using all relevant senses), listening, searching, reading, understanding and synthesizing. Students will learn to gather information through interviewing, auscultating (listening with a stethoscope), palpating, smelling, percussing, and reviewing documents (such as reading charts and electronic documents). In addition, a student must be able to use, observe and use diagnostic aids and/or instruments directly or in an adaptive form for the purposes of gathering information.

Critical thinking

Students must be able to learn to use cognitive and information gathering skills to address individual patient/client needs by noticing, reasoning, interpreting, and responding in a safe, caring and appropriate manner.  This requires problem solving and judgment in order to analyze, integrate, synthesize, and apply information to the patient/client situation or context. Students must be able to become familiar with clinical models, theoretical nursing frameworks, and scholarly evidence in order to critically appraise these, and interpret and apply them in a particular patient/client context.

Physical/motor abilities

To succeed in a nursing program, students must have sufficient fine motor skills, physical endurance, physical strength and mobility to learn the clinical skills required to safely care for clients.³

Examples include:⁴

Mobility	Move within small spaces. Raise equipment above shoulders. Bend and reach. Walk, stand, and maintain balance.
Fine Motor Skills	Manual dexterity to pick up, grasp and manipulate small objects with hands, with and without gloves.  Use a computer. Perform complex sequences of hand/eye coordination, e.g., preparing and giving an injection.
Physical Endurance	Correctly sustain repetitive movements (e.g., Cardio-Pulmonary Resuscitation). Work for up to 12 hours, with occasional rest times.
Physical Strength	Support clients with position changes, e.g., bed to chair. Move, push, pull, and/or carry objects, e.g., computers, medication carts, lift machines. Use upper body strength for Cardio-Pulmonary Resuscitation.

Resilience

Students must be able to adapt to and manage a range of unexpected, changing, stressful, emotionally charged, and/or ethically challenging situations, for example respiratory arrest, bleeding, patient death, or disclosure of abuse. Students must be able to deal with academic requirements through prioritization of activities, effective time management, focus and discipline.  Some examples of academic requirements may include: presentations to colleagues, oral examinations, practical examinations, debates, and assignment deadlines. Students must be able to receive, reflect on and integrate constructive feedback. Students must be aware of their own emotions and behaviours and develop the ability to further regulate these in order to focus on required program activities. They must have the ability to recognize their own stress, develop stress management abilities and self-care strategies, including being able to seek resources and assistance when needed.

Ethics

Students entering a nursing program must have an interest in assisting individuals and their families and communities in achieving their goals, and to do so in ways that acknowledge ethical values. The CNO has identified the following values as being most important to providing nursing care in Ontario⁵:  client well-being, client choice, privacy and confidentiality, respect for life, maintaining commitments, truthfulness, and fairness. To succeed in nursing, students must demonstrate integrity, sensitivity, compassion, and concern for others including clients, peers, and colleagues with whom they work collaboratively to build trusting relationships. They must be respectful of the individuality and diversity of others, regardless of their background characteristics such as age, health status, place of origin, race, culture, ethnicity, political or spiritual beliefs, socio-economic status, marital status, occupation, sex, gender identity, sexual orientation, lifestyle, mental ability, or physical ability.

Communication/Interpersonal abilities

The ability to develop mature, sensitive, and effective relationships with patients, families and other members of the health care team is required. This includes the ability to communicate with and relate to other people in a caring manner.

Students must have the ability to develop excellent observational, listening, oral and written communication skills, as well as to develop the capacity to sensitively perceive and convey verbal and non-verbal information effectively and efficiently. Students must also be able to develop the ability to coherently summarize the patient/client condition, assessment, and intervention plan, both verbally and in text, in compliance with regulatory and organizational record-keeping standards and privacy and confidentiality legislation and standards. 

Examples include:

• Hear, speak, write, and comprehend the principal language or languages of the program
• Learn to understand and respond to patient and colleague perspectives
• Become aware of and respond to the body language of oneself and others
• Develop an understanding and use of clinical terminology
• Learn to document pertinent patient findings in writing or in electronic format

Approved by COUPN January 2019

Statement on Accommodation of Students with Disabilities

The Lawrence Bloomberg Faculty of Nursing is committed to ensuring that students are afforded an academic environment that is dedicated to the advancement of learning and that is based on the principles of equitable access and individual dignity; as such, the Faculty is committed to facilitating the integration of students with disabilities into the University community. The Lawrence Bloomberg Faculty of Nursing also strives to preserve the academic integrity of the University and the program by affirming that all students satisfy the essential requirements of the program and program courses.

Each student with a disability is entitled to reasonable accommodation that will assist her/him to meet the program standards and academic requirements.  Reasonable accommodation cannot compromise the essential requirements of a program or client/patient safety and well-being. The purpose of a reasonable accommodation is to ensure the student with a disability has the same opportunity as his/her student peers to attain the required operational level but is not meant to guarantee success in the program.

Exploring reasonable accommodation options may involve the exercise of flexibility by both the University and the student with a disability, while maintaining the academic and technical standards and requirements of the program. The student with a disability must be able to demonstrate the requisite knowledge and behaviours, and perform the necessary skills independently and safely.  In rare circumstances an intermediary may be appropriate.  Instances when an intermediary may not be appropriate include, for example, where the intermediary has to provide cognitive support; or is a substitute for cognitive skills; or is solely conducting an assessment or treatment; or supplements clinical reasoning or judgment. The appropriateness of an intermediary will be assessed on a case by case basis.

Before accepting an offer of admission, students who may require disability related accommodations are strongly advised to review the policies, procedures, and regulations regarding accommodations and consult with the University’s Accessibility Services and the Lawrence Bloomberg Faculty of Nursing. Please note that certain accommodations obtained in previous educational settings may not be appropriate, particularly with respect to clinical requirements. If admitted, students will be required to follow the policies and procedures of the University and Lawrence Bloomberg Faculty of Nursing within which the program is located.

NOTE:  specific programs in Ontario may have additional program specific essential requirements.

Approved by COUPN January 2019

1. https://www.cno.org/globalassets/docs/reg/41037-entry-to-practice-competencies- ↩︎
2. http://www.cno.org/en/become-a-nurse/registration-requirements/ ↩︎
3. These abilities could be demonstrated with or without accommodations, as noted in the Context section above. ↩︎
4. Modified from, “Representative Skills, Abilities, and Capacities for the Bachelor of Nursing Program,” University of Manitoba ↩︎
5. http://www.cno.org/globalassets/docs/prac/41034_ethics.pdf. ↩︎