Overcoming ESL/EAL Challenges Addendum

When I wrote my “Overcoming ESL/EAL Challenges while in Nursing School” blog and published it as part one and part two, I did not intend for there to be a third.  However, our Educators in Nursing readers, Kaplan experts, and Nursing Directors in Oklahoma provided me with some fabulous feedback, thought-provoking questions, and verbal food-for-thought.  So here goes the unplanned addendum…

Question: You mentioned the TOEFL, IELTS, and MELAB in your earlier blogs, but what scores exactly are required on those tests?

Answer: The NCSBN has a policy position on English proficiency which states that “domestic and international nurses need to [be] proficient in written and spoken English skills” (NCSBN, 2003). When the NCSBN makes a cut-score recommendation, individual state boards of nursing can use those levels to decide what level of English proficiency is needed for entry-level nurses in their state.

For example, the NCSBN has made a score recommendation on the following exams:

1. The Test of English as a Foreign Language (TOEFL) with a passing score of 560 paper based or 220 computer based, or;
2. The Test of English as a Foreign Language (TOEFL) internet based test (iBT) with a minimum passing score of 83.
3. Receipt of both the Test of Spoken English (TSE) with a minimum score of 50 and the Test of Written English (TWE) with a minimum score of 4.0, or;
4. The International English Language Testing System (IELTS) with a passing standard of an overall score of 6.5 with a minimum of 6.0 in all of the four modules.
5. The Cambridge Michigan Language Assessments (CaMLA) MELAB with a total passing score of 81 and a speaking section score of 3.
6. The Pearson Test of English (PTE) with an academic overall score of 55 with no sub-cores lower than 50.

However, the Texas Board of Nursing has chosen to accept only recommendations 1-4 as proof of English proficiency.

Question: The NCLEX-PN® is written at an 8^th grade reading comprehension level, whereas the NCLEX-RN® is written at a 10^th grade reading comprehension level.  How do NCSBN’s recommendations compare with grade-level reading comprehension skills?

Answer:  The jury is still out on that one…  National Council sets a reading level of 10th grade, because they want to ensure that the NCLEX exams are testing the minimum set competency for nursing and not language or reading comprehension.  However, a school should not base English proficiency on a given grade level because nursing textbooks are usually written at 13+ grade levels, and all students need a proficiency level that enables them to master the nursing curriculum.

Question:  What do individual TOEFL scores mean in terms of proficiency level?

Answer:  According to ETS (who creates and administers the TOEFL exam), on the TOEFL Internet Based Test (iBT), each skills scores are divided into the following:  low, medium, and high proficiency.

The table provided above is from the ETS website.  National Council recommends a cut-score of 83 or higher which would correspond to an average score of 20.75 on each subsection of the exam. This score is on the high end of “intermediate” in reading and listening and a “fair” level in speaking and writing.

Question: Do you know of any resources that we can use to “grade” an application essay? 

Answer:  Some ESL/EAL exams have a writing section on them, many of which will provide you with a copy of the student’s responses, but some nursing schools also request application essays.  One idea a colleague of mine had was using a tool, if you will, to try and give a numerical score or value to the essay.  I’m pleased to share with you a great function of Microsoft Word.  Go here, and you’ll find the steps to follow in Microsoft Word and Outlook. Both have an option that will give a “readability level,” based on grades, whenever you perform a spelling and grammar check.  The article recommends a level of at least 8th grade for most documents.  Theoretically, this procedure would allow you the chance to see at which grade level a student  was writing and then consider that as a part of his or her application, but you’ll want to keep in mind that it could be heavily edited by a professional.

In the meantime, since this is obviously a topic on which we can all learn more, I’d like to invite you to an upcoming free CEU event that Dr. Susan Sanders (of Kaplan Nursing) is hosting.  The event is called “Increasing Comprehension of Test Items by EAL Nursing Students” and it will be held in our Classroom Anywhere live and online learning platform at 8pm EST/ 7pm CST on Wednesday, October 16th, 2013.    You can learn more and register here.  We hope to “see” you there, and as always, we hope to continue to receive feedback on this extremely important topic.