Stephen Cope has been teaching English as a foreign language for 17 years, and has specialised in IELTS training since 2009.

We recently spoke to Stephen to get his perspective on IELTS testing of foreign nurses. His insights build upon many of those presented in our previous report, but also shed new light on issues that are perhaps being overlooked.

Only 1 of 9 nurses met the NMC’s IELTS criteria in spite of 100 hours of training

Stephen’s experience and knowledge makes him a sought-after language trainer across the globe. But even with his support, nurses aren’t meeting the NMC’s challenging criteria for IELTS.

In a batch of data taken in Italy, 8 of 9 nurses coached by Stephen failed to hit the NMC’s benchmark, largely due to the requirement of achieving 7 in every module. In fact, a change in this requirement to 6.5 in each category would have seen 4 of 9 nurses passing, rather than 1.

Additionally, all candidates were within 0.5 of the required 7 in speaking and reading, while far fewer were close to the benchmark for writing and listening.

These patterns reflect everything we’ve discussed in our previous IELTS reports. Once again, small changes would have a big impact on success rates.

Is the NMC sufficiently scrutinising how IELTS relates to a nurse’s on-the-job experience?

Stephen raised some excellent questions that must be asked of IELTS testing of foreign nurses in its current format.

To what extent should personality or a nurse’s approach to communication be allowed to compensate for grammatical inaccuracy? This, in particular, seems pertinent – after all, does the frantic shorthand and note-taking we associate with busy nursing really require an ‘academic’ appreciation of grammar?

Stephen also rightly questions whether native English speakers at hospitals –patients or staff – are being assessed and scrutinised to build a formalised understanding of what the expectation is for foreign nurses. This again is an essential consideration given that any benchmark must have a clear and proven precedent. But as previously discussed, if evidence of this exists, it certainly isn’t easy to find.

There is an ‘implicit assumption’ that native English nurses possess sufficient linguistic competence

According to Stephen, ‘it would be a valuable piece of research to find out how native English nurses performed in an academic IELTS test’. Stephen here echoes a growing consensus that there is an implicit unfairness in the way the English skills of native nurses aren’t questioned.

If tested, anecdotal evidence suggests that a score of 7 in every category might be beyond the reach of many British nurses. After all, 7 is a higher benchmark than those used by many of the UK’s top universities.

Do we need ‘good users’ or ‘competent users’?

An IELTS score of 6-6.5 reflects a ‘competent user’ and a score of 7 reflects a ‘good user’. A competent user is able to ‘use and understand fairly complex language’, while a good user is said to ‘handle complex language well and understand detailed reasoning’. Stephen rightly therefore questions the logic of the level 7 requirement.

The description of a competent user sounds very much like someone working in a structured and predictable environment, like a nurse. Meanwhile, the level describing a good user sounds, according to Stephen,‘more central to the role of a doctor than that of a nurse’.

Once again, the NMC ought to have clear evidence of why ‘good’ and not ‘competent’ is the requirement.

‘Potential brain drain’
Having spent years helping to bring international nurses to the UK, Stephen is alarmed by the impact that IELTS level 7 is having.

With options limited after failures, Ireland could become a far better option – where a 6.5 in listening and reading is accepted. The result could be a brain drain, with the UK losing the best and brightest young international nurses.

Click here to read our original report.

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