Responsive Policy Making and Implementation: An Analysis of Ongoing Licensure Reforms for Internationally Educated Nurses in Canada.

Between 2022 and 2024, Canadian nursing regulators significantly reformed licensure pathways for Internationally Educated Nurses (IENs) to address worsening workforce shortages. Since then, pathways have continued to evolve, illustrating a dynamic policy area. The objective of this article is to examine factors shaping changes to IEN licensure policy discourse and pathway design between 2024 and 2026. A comparative qualitative policy analysis of six nursing regulators across four provinces was conducted using publicly available grey literature, guided by the 3I + E framework and the READ approach. The findings suggest that IEN licensure reforms continue to be shaped by ongoing labour mobility, political, and economic pressures. Regulatory pathways increasingly emphasize substantial equivalence pathways with increased verification and competency oversight measures. Despite an increased supply of licensed nurses, ongoing integration challenges indicate that licensure is only one component of the solution. Findings also highlight the need for adaptive and coordinated policy responses across interconnected workforce, immigration, education, and healthcare systems.