Quality improvement of the national examination for nurses and midwives in Lao Peoples Democratic Republic.

The quality of national licensing examinations is critical to ensuring a competent health workforce. This communication analyzes the process of improving examination questions for nurses and midwives in the Lao People's Democratic Republic (Lao PDR). Following the Ministry of Health's 2014 amendment to the Law on Health Care and the 2015 approval of the Strategy on Healthcare Professional Licensing and Registration System, a national licensing examination was initiated. Supported by the Japan International Cooperation Agency, the Nursing and Midwifery Board has conducted the annual examination since 2019, with 2,000 candidates participating to date. A continuous quality improvement cycle involving statistical analysis, revision, and new question creation has been implemented. Results showed significant improvement in key indicators such as correct answer rates and point-biserial correlations. These efforts highlight the importance of continuous quality improvement and collaboration between educators and clinicians, providing a model for enhancing healthcare professional licensing examinations.