Canadian nursing students are calling for changes to the current entry-to-practice exam which they say is loaded with American content and lacks crucial Canadian context.

The calls were made Friday at the Canadian Nursing Students' Association national conference in Winnipeg. More than 400 nursing students gathered for the event and many signed a related petition.

The new exam was developed by the National Council of State Boards of Nursing in the United States and replaced the Canadian Registered Nurses Exam in 2015. 

Students must pass the new exam to be able to practice nursing. If they fail, they can retake it after 45 days.

Under the old test, an average of 87 per cent passed. Now that's plummeted to 69.7 per cent. Substantially fewer Francophones are passing — just 27.1 per cent. 

Bryce Boynton, president of the Canadian Nursing Students Association, blames the low pass rate among French students on translation errors and a lack of French preparatory materials. 

"The translation is very poor," he said. "So they are going into this at a disadvantage compared to Anglophones."

The new test was adopted, said Boynton, because it touted more accessibility — the test is a computer adaptive exam and replaced the traditional paper and pencil.

But, he said, the American context and content is leaving nursing students drawing a blank. The low success rate is also encouraging schools to focus more on exam preparation rather than clinical work and training, he said.

"The validity is really in question right now," he said. "Because equivalency of Canadian nursing isn't being tested like it was on the old exam."

Examples of areas previously covered in the old exam but not in the new one are Indigenous health care as well as social determinants of health in Canada, said Boynton.