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Nurse Continence Advisor


The Nurse Continence Advisor (NCA) is an independent practice role with a focus on conservative methods of managing urinary and fecal incontinence. It was established in 1997 as a continuing education certificate program at McMaster University School of Nursing using a self-directed, problem-oriented approach to developing evidence-based practice in continence care. It is the only university-based program for educating nurse continence advisors offered in North American. 

The Nursing Continence Advisor Distance Education Certificate Program is a one year program that combines academic study with preceptored and independent clinical practice and has been recognized for 2 full credits for nurses in post diploma programs at universities across the country. NCA's are now practicing in most provinces. The  Canadian Nurse Continence Advisors Association (CNCA) was formed in 2000 and is  affiliate group within Canadian Nurses Association.


NCA Distance Education Program

The NCA Distance Education Program is designed for registered nurses (RN) working in areas where they care for patients with incontinence in hospital, outpatient or community settings (such as geriatrics, rehabilitation, urology, gynecology and geriatrics). The program uses a self-directed, problem-oriented approach to assessment and management of incontinence. There are two components in this certificate program. In the first, students complete a series of 10 modules — one every 6 weeks — that are submitted by email to a course tutor for feedback and marking. The clinical component of the program provides the student with the opportunity to gain experience in the NCA role by working under the supervision of an experienced NCA and then progress to an independent practice portion. Academic credit has been granted to post-diploma  nurses enrolled in undergraduate programs at University of British Columbia, University of Manitoba, McMaster University, and St. Frances Xavier University.


  1. To understand the role of the NCA in promotion of continence and conservative management of incontinence as it relates to promoting self-management. 
  2. To gain knowledge of the anatomy and physiology and the pathophysiology of incontinence.
  3. To develop a holistic approach to the assessment of incontinence, which encompasses the biopsychosocial aspects of health.
  4. To develop an in-depth knowledge of the conservative behavioral and educational interventions used in management of incontinence.
  5. To gain an understanding of the impact of incontinence on the client's well-being and quality of life.


  1. Continence Promotion and Management of Incontinence This course consists of 10 modules designed on a self-directed, problem-based learning (PBL) model. Each module builds on the previous one and addresses a specific type of incontinence problem. Students complete the readings for the module, answer the questions pertaining to each problem and submit them to the course tutor for evaluation and feedback. Modules are submitted on an assigned schedule at six week intervals. Students are expected to:

    • identify their own learning needs;
    • critically analyze a broad knowledge base in each module;
    • apply the knowledge to the specific incontinence problem by identifying the factors which may be contributing to the incontinence; and
    • make recommendations regarding an appropriate plan of treatment option 
  2. Clinical Practice in Continence Care This course consists of a total of 150 hours of clinical experience. Students may start their clinical practice component once they have completed the first 4 modules of the education program which is usually by March of the following year. The first 75 hours of clinical are completed with an NCA preceptor and must be finished before starting their own independent clinical time. The remaining 75 hours of independent practice is completed in the student’s own clinical setting. All students must be employed in settings where they can  complete their independent clinical component of the program. Successful completion of the clinical course is based on the preceptor’s feedback and submission of in-depth case summaries.

Students must have an NCA preceptor to supervise their clinical experience. The preceptor must be an experienced certified NCA with a minimum of 2 years experience in the role. The preceptor must be identified prior to applying for the course and provide a letter of support for the applicant. If you do not know or have a question about a potential preceptor, contact Dr. Jennifer Skelly for help.

Students must be able to arrange for the necessary clinical time or leave of absence needed to complete the clinical requirements of the course.

* The course must be completed in 14 months or there is an additional charge of $250.00 for a further 4 month extension.


$1,200 CND: Tuition fee includes course workbook, textbooks and all reference articles, which will be sent directly to the student when the tuition has been paid. 

The student will be invoiced once confirmation of acceptance into the program is received. 


NCA Application

Students are accepted into the program in September of each year. Enrollment is limited. Early registration is encouraged.

Deadlines for receipt of applications to the program:

Application Deadline

Program Begins

June 30th each year

September 1st each year

Applying to the Program

Print, fill out and mail the Application Form

Your application should include the following:

  1. Letter describing your  reason for applying to the program and how you plan to incorporate the NCA role into your work setting. Please describe your current client population and the potential for incontinence assessment or plans to establish a program.
  2. Letter of support from your current employer: The letter should confirm the employer's support to provide the necessary time to complete the clinical component of the program and to allow you to practice the role once completed.
  3. Letter of support from your preceptor: The letter must indicate her/his willingness to provide supervision for the clinical component of the course.
  4. An up to date curriculum vitae or summary of relevant work experience.

Applicants will receive written notification of acceptance into the program. A pre-test questionnaire will accompany the confirmation notice. All program materials will be sent directly to the student following completion of the pre-test questionnaire.

NCA Scholarship

NCA Scholarship

The purpose of this scholarship is to provide support to Registered Nurses entering the Nurse Continence Advisor Distance Education Program at McMaster University. 

One $1000 CND scholarship will be awarded for studies each year.

Candidates must:

  • Be registered to practice nursing in a Canadian province.
  • Have gained acceptance to the Nurse Continence Education program at McMaster University.
  • Exhibit interest in, and potential for, a career in continence promotion in Canada.
  • Be a Canadian citizen or landed immigrant at the time of taking up the award.
  • Submit an up-to-date resume with 2 letters of support.
  • Outline reasons for wanting to become a Continence Advisor and a plan for how the role will be implemented in the community.

Deadline to apply: September 30th each year. 

The scholarship is administered by the CNCA and further information regarding criteria can be obtained through the CNCA.

Please send all applications or inquiries to: 

Dr. Jennifer Skelly
School of Nursing
McMaster University
1280 Main St. W.
Hamilton, ON
L8S 4K1

NCA Useful Links

Related Pages

For more information, contact:

Dr. Jennifer Skelly

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