Ontario Selected 5,000 Nurses for Assessment. Here Is What Happened.

Ontario does not count CPD hours for nurses. It selects several thousand of them a year for assessment instead, publishes what happened to every one, and has done so with the same metrics for five years. It is the most transparent CPD enforcement data published by any regulator we have examined outside the UK.

Five thousand nurses, two cycles, six weeks

From the College of Nurses of Ontario's Quality Assurance Committee annual report: "In 2025, a total of 5,000, practicing nurses were selected, using a random and risk-based process, to participate in QA Assessment during two separate selection cycles (Spring and Fall). This included a total of 4,300 nurses for Part A and 700 nurses for Part B."

Note "random and risk-based" — it is not a pure lottery. More on what counts as risk below.

Selected nurses get six weeks: "All nurses selected for QA Assessment are provided six weeks to complete their activities. Extensions and deferrals can be requested."

The report is published by CNO.

How likely is it, really

CNO does not publish a selection rate, so here is the arithmetic with both inputs stated. The denominator, from CNO's own statistics report, is "190,896 nurses renewing at least one certificate of registration in the General or Extended Class." Five thousand of 190,896 is 2.62% — roughly one nurse in 38 each year.

That is our calculation, not a CNO figure, and the denominator combines the General and Extended classes. Treat it as an order of magnitude rather than a published rate. The statistics report is also published by CNO.

For comparison, the UK's HCPC audits a random 2.5% of registrants at renewal. Two regulators on opposite sides of the Atlantic, with completely different CPD models — hours-based in the UK, no hours at all in Ontario — have landed on almost exactly the same sampling intensity.

The escalation nobody writes about

Here is the mechanism that makes Ontario distinctive. Failing to engage with Part A does not produce a fine or a suspension. It produces more assessment.

"Nurses who were non-compliant in submitting their Part A QA Assessment activities by the assigned deadline dates were directed by QA Committee to additionally complete Part B QA Assessment activities."

In 2025, 306 nurses were escalated this way. And Part B is substantially more work: "Part B assessment requires a registrant to complete and submit a written learning plan, a Code of Conduct practice activity, and for Nurse Practitioners (NPs) an additional NP case example. These completed activities are assessed by a QA Peer Coach to determine a more in-depth assessment of a nurse's knowledge, skill and judgement."

The sanction for ignoring a light-touch process is a heavy-touch one. That is a genuinely different design from a penalty regime, and it is cheaper to comply with at the first stage than at the second.

What the committee can actually do

The ladder, in CNO's words: the Committee "will either grant or deny requests for deferrals or extensions, direct members to the Inquiries Complaints and Reports Committee (ICRC) for lack of participation, specify remedial support if unsatisfactory or direct nurses to exit the program if they have been assessed as satisfactory."

Referral to the ICRC is the serious end — that is the complaints and discipline stream, not the quality assurance stream.

The 2025 outcomes in full

CNO publishes the disposition of every selected nurse:

• 3,976 completed Part A and exited the programme; 2 remained in progress
• 306 directed to Part B for non-compliance
• 620 assessed by QA Peer Assessors and exited having completed satisfactorily; 290 still in progress at year end
• Directed to remediation: 10
• Referred to the ICRC: 43
• Granted a deferral: 13
• Moved to non-practising: 15; resigned: 30; deceased: 1

One figure is worth isolating because it only becomes visible a year later: "Of nurses selected in 2024, a total of 61 (1.2%) have been referred to the ICRC as of December 2025." The in-year referral count understates the eventual total, because cases take time to work through. Any single-year comparison of referral rates is comparing an incomplete number with a complete one.

Five years of the same metrics

Selection volume and satisfactory completion, 2021 to 2025:

• Selected: 392 → 371 → 1,627 → 5,020 → 5,000
• Satisfactory: 79.6% → 82.2% → 89.4% → 91.22% → 91.92%

Selection volume rose roughly thirteenfold while the satisfactory rate climbed twelve points. Both directions are worth noticing: the programme got much bigger and outcomes improved rather than degrading.

CNO is careful about over-reading its own data, and so are we: "While the rate of nurses referred to ICRC in 2025 is higher than previous years, there is not a statistically significant difference."

The risk criterion that tells you something

In explaining the referral figures, CNO names one of its risk-selection inputs, and it is not a clinical one: "a higher number of nurses selected for the risk group of recurring late fees, which is a proxy for ungovernability."

Recurring late fees as a proxy for ungovernability. That is a regulator saying out loud that administrative sloppiness predicts professional risk, and using it to target assessment. If you are a registrant anywhere, the practical lesson generalises: the things that get you noticed are often not the things you think are being measured.

How this compares

Ontario publishes volumes, outcomes, a five-year trend and its own statistical caveats. Victoria's legal regulator publishes comparable detail for lawyers, including a count of false compliance declarations, which we cover in Victoria's CPD audit. South Africa's HPCSA publishes the mechanism and no numbers at all, covered in what happens at an HPCSA CPD audit.

The underlying Canadian requirements, including why Ontario counts no hours, are in our guide to nursing CPD requirements by province.

This article quotes CNO's published reports. Note that the source's statistical appendix contains two transcription errors against its own prose; we have used the prose figures. Verify with CNO before relying on any number.