HOW DIFFERENT IS NEXT GEN NCLEX FROM THE CURRENT NCLEX?
NCSBN EXPERT DETAILS HOW TO BE PREPARED FOR CHANGES WITH THE NEXT GENERATION NCLEX

Stay up-to-date on the Next Generation NCLEX.
In a recent discussion with hundreds of ATI clients during a session of “The ATI Talk,” we got answers from Phil Dickison, PhD, RN, Chief Officer, Operations & Examinations, National Council of State Boards of Nursing (NCSBN).
WHAT WON’T CHANGE FROM THE CURRENT NCLEX?
- The exam will continue to measure the same critical content areas.
- Most items on the minimum-length exam will be standard NCLEX items.
- The scoring scale will not change.
- The exam will remain computer-adaptive.
Content areas covered. The reason behind changing the NCLEX was to begin measuring clinical judgment, but the exam’s focus will not change in terms of the overall content it covers. “Just because we’re measuring clinical judgment doesn’t mean all the other stuff that we’ve been measuring is not important; it’s still important,” Dr. Dickison said. Most of the exam, he added, “will be the same as what candidates have seen for the last 4 years.”
Majority of item types. Dr. Dickison cleared up a misconception for many that the revised exam will focus exclusively on new NGN-style item types. “The majority of items on a minimum-length exam will still be the standard NCLEX item types,” he said.
Same scoring scale. "We’ve kept that scale stable for 20 years,” Dr. Dickison said. Going forward from the NGN, the exam will continue to offer longitudinal comparisons of nurse ability; scores will be comparable from 4 years ago to a year after the NGN launches.
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WHAT WILL CHANGE FROM THE CURRENT NCLEX?
- Each candidate will see a set amount of case studies.
- The test will use partial-credit scoring.
- Students may also receive single, standalone, clinical judgment item types called bowties.
Case studies. Case studies on the NGN will provide a good tactic for measuring clinical judgment as each question builds on the next. Case study items will reflect the kind of real-world decisions nurses must make in healthcare settings. (Toward the end of March, Dr. Dickison added, the NCSBN would be able to provide more details on these.)
Partial-credit scoring. Dr. Dickison said some new item types on the NGN won’t be scored as simply right or wrong. Instead, candidates will receive full, partial, or no credit for an answer based on the selected response. (Dr. Dickison said NCSBN should have more details on this in October.)
Bowtie items. Resembling a bowtie onscreen, this item type offers 2 antecedents on one side and 2 outcomes on the other. Test-takers are asked a question that requires them to pull the antecedent to the outcome based on a pathophysiology or some nursing-care characteristic. All candidates may see one of these standalone item types focused on clinical judgment, Dr. Dickison said. But candidates that reach the minimum-length exam may receive as much as 10% of these items on the rest of their exam.
