Whenever we have new information about how NCSBN's advancements and modifications to the Next Generation NCLEX (NGN) will impact you and your students, count on finding it here in videos, interviews, articles, infographics, and industry bulletins based on information directly from the source: NCSBN. Plus, we're always working on new resources to help you better understand the crucial connection between clinical judgment and the ability of a new nurse to be competent and safe. That connection is a key reason for the development of the Next Generation NCLEX, so we'll gather that information here, as well, to make it easy for you to find the information you need.
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ATI'S EXPERTS WILL HELP YOU ANSWER THE CRUCIAL QUESTION: WHY DO WE NEED A NEW NCLEX NOW?
(HINT: NEW NURSES FACE MORE COMPLEX CLIENT NEEDS IN A RAPIDLY CHANGING HEALTHCARE ENVIRONMENT.)
Consider: When you were in nursing school, your instructors probably didn't talk about clinical judgment — at least not using that term. So why is it important to assess this skill today?
Basically, general nursing in current times is much more complex. More than 50 years ago, when the nursing process was first defined, nurses provided care that was fairly basic (unless the nurse worked in a specialty area such as critical care, ob-gyn, or med-surg).
Today, healthcare is more dynamic. It moves at a rapid pace. And nurses now care for people who are much sicker and who have multiple, complex problems compared to clients in the past.
The NCSBN confirmed this reality by viewing new nurses at work. This observational practice analysis verified how often new nurses use clinical judgment in their daily tasks in today's practice settings. The organization realized it was critical to change the NCLEX so that the exam can accurately assess candidates’ clinical judgment skills to ensure public safety.
OUR EXPERTS RELY ON RESEARCH FROM NCSBN
THE NATIONAL COUNCIL OF STATE BOARDS OF NURSING HAS BEEN PLANNING FOR THE NEXT GENERATION NCLEX FOR MANY YEARS.
In 2009, the NCSBN held conversations with professionals in clinical practice and other nursing experts. They determined that the current level of decision-making in nursing had led to a large number of practice errors by entry-level nurses.
Studies showed that as many as 65% of entry-level nurse errors were related to poor clinical decision-making and that only 20% of employers of new nurses were satisfied with their decision-making capabilities.
From 2012-2014, the NCSBN collaborated on two studies about nursing practice and the entry- level nurse. Detailed in more than 2,500 pages, these studies established the need for clinical judgment as one of the top five skills required to enter nursing practice. Two other high-priority skills were problem-solving and critical thinking, which are both vital to clinical judgment. (The other two required skills were active listening and professional communication.)
The RN Nursing Knowledge Survey from 2017 offered more evidence of the need for clinical judgment. Newly licensed RNs, RN supervisors, and RN educators unanimously agreed on the importance of clinical judgment. LPN experts shared the same concerns.
As a result of these findings, the NCSBN determined it was vital to move forward with the Next Generation NCLEX (NGN) Project.
RESEARCH IS THE BACKBONE OF THE NCSBN' S PLAN.
The NCSBN’s team of researchers and psychometricians have followed eight evidence-based steps to prepare for the new version of the exam:
1) DEVELOP A CLINICAL JUDGMENT MODEL
The NCSBN developed a model of five interacting layers that illustrate the complex process of clinical judgment, including the context in which decisions are made.
2) CREATE ITEM PROTOTYPES
Measuring clinical judgment requires more unique item types than simple multiple-response questions, as well as different scoring methodologies, including penalties for answers indicating a lack of clinical judgment.
3) TEST ITEM USABILITY
Students, nurses, and educators have reviewed item prototypes to ensure they represent real-life clinical judgment scenarios.
4) COLLECT ITEM DATA
The NCSBN added a “Special Research Section” with new item types for select students to voluntarily answer after completion of the current NCLEX. Their responses don’ t impact their scores but do provide valuable insight on question fidelity.
5) RESEARCH MEASUREMENT
Psychometricians have received millions of data points from the responses to the “Special Research Sections.” Ongoing analysis has been determining which item types accurately measure clinical judgment and nursing competence.
6) BUILD TECHNOLOGY
The NCSBN is now developing the complex technology needed to support the new item types.
7) PERFORM ALPHA/BETA TESTS
Multiple evaluations will be necessary to assess test questions. The NCSBN is scrutinizing every item type for those providing the highest accuracy.
8) LAUNCH NEW NCLEX
After the operational phase of testing and building item types, the Next Generation NCLEX is scheduled to launch in April 2023.
THE PURPOSE OF THE SPECIAL RESEARCH SECTION
THIS SECTION OF THE CURRENT NCLEX IS A CRUCIAL FACTOR IN DEVELOPING THE NGN.
Starting in July 2017, the NCSBN began including a Special Research Section (SRS) as part of the NCLEX-RN exam for select candidates. In October 2020, it began offering an SRS to select PN candidates.
The SRS presents unique item types that are specially designed to evaluate the candidate’s clinical judgment skills. Candidates receive 30 minutes to complete the SRS after their standard NCLEX exam with no impact on their NCLEX score.Candidates' answers provide data to the NCSBN for use in testing and analyzing the new item types.
The NCSBN says, "This research helps identify Next Generation NCLEX (NGN) items that are at the appropriate difficulty level for entry-level nurses — items that are neither too difficult nor too easy. The research section also helps gather data related to the time required to respond to the new NGN items. Validating both the content and the measurement properties of items is essential to developing a standard-leading assessment of clinical judgment."