What's the latest news on Next Gen NCLEX?
• When will it be released?
• What new item types will be on it?
• How can you prepare?
Dr. Sommer, ATI Vice President and Chief Nursing Officer, has gathered the most essential facts to fill you in on what's accurate — and what's not. With info gathered directly from the National Council of State Boards of Nursing (NCSBN), find out what's ahead with the Next Generation NCLEX.
A full transcript of Dr. Sommer's video is located below the video.
Welcome to the update on NCSBN's Next Generation NCLEX project. ATI is pleased to share this latest information on this important topic with you. It is my pleasure to introduce Dr. Sheryl Sommer, Vice President and Chief Nursing Officer at ATI. Dr. Sommer is an experienced, visionary leader in nursing education. She has been a reviewer for several nursing journals and author of numerous publications. Her passion for nursing education is evident in her work guiding development of products to promote the development of clinical judgment, helping faculty develop skills in areas such as clinical judgment, curriculum development, and student evaluation. Please join Dr. Sommer as she shares information about the Next Generation NCLEX.
Dr. Sheryl Sommer:
Thank you for joining the webinar. The goal of NCSBN's Next Generation NCLEX project is to determine if adjustments are needed to be made. They're wondering if they need to make adjustments to the NCLEX to adequately measure the clinical judgment ability of the candidates taking the test. At ATI, we gather information about the Next Generation NCLEX from official statements made by the National Council of State Boards of Nursing. I had the opportunity to interview Dr. Phil Dickison who is NCSBN's chief measurement officer, about the Next Generation NCLEX project. The interview has been divided into segments and is posted to the ATI blog, which is available on the ATI website.
The interview with Dr. Dickison talks about NCSBN's motive and objectives for the Next Generation NCLEX project, as well as how NCSBN developed the clinical judgment model. I encourage you to check out the blogs.
Other strategies that we use to gather accurate information include direct communication with Dr. Dickison, reading the Next Generation NCLEX news publications, and attending NCSBN presentations.
3 key points
There are three key points that I plan to share with you during this webinar today. So let's get started.
- First nurses need stronger clinical judgment skills.
- Second, clinical judgment is part of both the RN and the PN practice.
- And finally there will be no new NCLEX before 2023.
So we're going to dig into each of those a little bit more.
The Special Research Section
The Special Research Section from an NCLEX-RN began in 2017 and continues today. This is allowing NCSBN to carefully analyze strategies to evaluate each candidate's clinical judgment ability.
Because the research is continuing, no final decisions have been made regarding the details of a Next Generation NCLEX.
NCSBN identified knowledge and clinical judgment as the two critical elements in nursing. A nurse with strong clinical knowledge does not necessarily have good clinical judgment skills. However, to successfully make good clinical judgments, the nurse must have clinical knowledge.
All candidates taking the NCLEX-RN are invited to participate in the Special Research Section.
Over the course of 18 months, from July 2017 to December 2018, the response rate has been just overwhelmingly positive.
They've had over 85 percent participation. Numerous item types have been and continue to be tested by NCSBN.
As the testing progresses, modifications to item types are being made, and new formats are considered. The Special Research Section includes 10 traditional items that measure the clinical judgment and 10 Next Generation items to allow for statistical comparisons.
The research has found that students complete a Next Generation NCLEX item in less than one minute.
New item types
These are five item types that NCSBN sees as viable measures of clinical judgment ability at this time.
The NGN items will most likely be integrated with other items when a Next Generation NCLEX is released. NCSBN is currently researching the minimum and maximum number of items needed in a Next Generation NCLEX. So those numbers could change.
It's important to keep in mind that NCSBN has not finalized details about a potential Next Generation NCLEX.
They are still conducting research and have not yet released a final list of item types.
The importance of clinical judgment is supported in the literature and by the work of NCSBN. The NCSBN conducts a periodic practice analysis to evaluate the validity of the NCLEX test plan and to guide content distribution on that test. The recent practice analysis identified that three of the top high-priority skills for registered nurses are related to thinking.
They found that clinical judgment is linked to 46 percent of tasks performed by entry-level nurses.
In addition, problem solving and critical thinking are linked to more than 30 percent of tasks performed. Educating new nurses so they can develop strong clinical judgment skills is critical regardless of the ultimate outcome of a Next Generation NCLEX.
PN practice analysis
NCSBN recently completed a PN practice analysis, and they identified that clinical judgment is an important activity for practical nurses, as well as registered nurses. However, there are some differences related to the PN and RN scope of practice.
NCSBN has not yet shared specific details about these differences however. Specific research for a PN Next Generation NCLEX has not yet started. To date, NCSBN has not announced plans to begin conducting such research with PN candidates, so that's something that is yet to come.
If NCSBN decides to create a Next Generation NCLEX, they intend to release it for both RNs and PNs all at once. The NCSBN would like a Next Generation NCLEX to impact both types of prelicensure nursing programs at the same time.
Exploring technology
The NCSBN is also continuing to explore the necessary technology needed to support a Next Generation NCLEX. Items do not have a single correct answer the way that a multiple-choice item does. NGN items often have multiple questions within one item. This requires development of new scoring methods and the associated technology that goes with it.
This is an example of a CLOZE item, which is one of the item types that NCSBN is testing.
In this item, the candidate is asked to read the case study and refer to the information as they answer the question.
So, all of the client information is on the left-hand side. And then on the right side, you'll see the question asking which medications require clarification prior to administration. They would click on the dropdown boxes to make their selection.
Investigating scoring
NCSBN is investigating scoring methods, and this is a real important activity, because current scoring methods are not adequate to score these kinds of items. With a CLOZE item, for example, there are six questions within that item, and maximum points could be received for selecting all of the correct options. Points could be deducted if a distractor is selected. So there are different ways that they are looking at making the scoring happen. That research is being conducted at this time.
Official word soon
It seems clear that NCSBN is striving to create a Next Generation version of the NCLEX. However, we won't officially know until this summer when NCSBN says they will announce its decision sometime between June and August.
Levels of difficulty
The NCSBN research identified that there is a difference in the level of difficulty between steps in the NCSBN clinical judgment model and between the application items on the current NCLEX and the Next Generation items. So, for example, candidates found that cue recognition is easier than the step of taking action.
They've also found that a multiple-choice knowledge item is easier than a multiple-choice clinical judgment item.
And multiple-select knowledge items are easier than multiple-select clinical judgment items.
The 2019 NCLEX-RN does not include any new Next Generation NCLEX items. The only mention of the term clinical judgment in the 2019 NCLEX-RN detailed test plan is in the definition of the nursing process. That definition is the same as it was previously. So there is no change. 
The NCSBN says that the soonest there could possibly be a Next Generation NCLEX would be in 2023.
Providing solutions
At ATI, we realize that you need resources to support you and help your students develop clinical judgment skills. We have been focused on improving clinical judgment skills of students for quite some time.
Approximately 10 years ago, ATI released NurseLogic. It includes interactive tutorials that help students learn the foundational concepts of nursing as a profession. The ATI "Helix of success," which is pictured on the slide, provides the framework for the educational strategies and materials to facilitate classroom, clinical, and NCLEX success.
The vertical strands of that helix are knowledge and clinical judgment, which serve as the foundation of nursing.
Through NCSBN's work, they have also identified knowledge and clinical judgment as the foundational elements in nursing.
The modules in NurseLogic focus on knowledge and clinical judgment, nursing concepts, priority-setting frameworks, and testing and remediation.
The NCLEX Experience is the latest product we've developed to educate faculty and students about the Next Generation NCLEX. Videos present information about the NCLEX experience, the Next Generation NCLEX research, strategies and tips for taking the NCLEX, and alternate-format item types. Now that the NCSBN has announced that clinical judgment is an important activity of a practical nurse, ATI is exploring the addition of a PN version of the NCLEX experience. To date, the NCSBN has not yet released information specific to a Next Generation NCLEX for PNs or any research in that line.
The NCLEX Experience provides students with the opportunity to answer questions in challenging new formats that focus on their clinical judgment capabilities. For example, this highlight item, partially pictured on the screen, requires students to make clinical judgments about medication administration.
Real Life scenarios were designed to provide students with an opportunity to respond to client-care questions related to clinical situations. This is particularly useful in light of challenging experiences that faculty are having in getting clinical available for students and experiences that can offer the desired learning outcomes.
Real Life delivers interactive online learning.
The product features real people to help engage learners on an emotional level. Scenarios help improve clinical reasoning, patient safety, and clinical assessment skills. Experience with clinical situations in Real Life help students improve their clinical performance, and these scenarios allow students to see and feel the consequences of their decisions in a safe environment promoting safe client care in clinical.
HealthAssess is a new product that will be coming soon. It uses 12 learning modules organized by major body system to develop health assessment skills.
Tutorials are interactive activities that happen in HealthAssess, and you also have virtual demonstrations of assessments performed on a diverse set of clients. While performing this health assessment, students must use clinical judgment skills to intervene when the client presents with problems needing attention.
Nurse's Touch is another product that supports the development of clinical judgment skills. Its purpose is to help students sharpen their professional and interpersonal skills, including therapeutic communication, to help them face the emotional and physical demands that come with being a nurse. It features tutorials, case studies, assessments, and high-quality live action video.
Nurse's Touch videos simulate sensitive but common scenarios that nurses face on the job. Students learn how to communicate effectively with patients, families, peers, and members of the healthcare team in both therapeutic and nontherapeutic situations. These types of communication skills are crucial, and the clinical judgment related to it is very important to ensure that nurses respond appropriately with both verbal and nonverbal reactions. The scenarios involve client-care situations using unfolding clinical scenarios so that students also learn how to apply leadership concepts and decision-making skills.
ATI is continuing work related to the Next Generation NCLEX. We are evaluating new item types. We're exploring scoring methods. We're developing new items. And we're keeping you updated on the most recent Next Generation NCLEX information as it becomes available.
We have a thorough understanding of NCSBN's clinical judgment model. We encourage you to keep in mind that the clinical judgment model is very similar to the nursing process. ATI has created definitions for each step of this clinical judgment model, and we have defined each step of the model and distinguished each of them from each other. ATI has created multidisciplinary teams to write items. Members include practicing nurses, our nurse and content experts, psychometricians, and also editors. As students use the NCLEX Experience, we are also collecting data to evaluate the effectiveness of the new clinical judgment items.
We are enhancing current products and creating additional solutions to help you prepare students so that they have strong clinical judgment skills.
FAQs
I have a couple of questions that we frequently get, and I thought we would talk about those as we wrap up this webinar. ATI is actively writing new items that follow the Next Generation NCLEX item types. And we're using the examples shared from NCSBN. So ATI is also developing scoring ways to actually measure these items as students take them. And so that is what we're doing to help evaluate clinical judgment skills.
Next question: How soon will ATI release assessments that include new item types?
Sample items are available now as part of the NCLEX Experience on the ATI platform.
A timeline for releasing additional assessments with new item types will be determined after NCSBN announces their decision about a Next Generation NCLEX. At this time, NCSBN has not announced a final decision about releasing a Next Generation NCLEX, new item types, specific differences between an RN and PN test, or a final release date. Products specifically aligned with the Next Generation NCLEX cannot be developed until these decisions are all finalized. We encourage you to be cautious if you hear someone say that they have products -- particularly assessments -- that are available now that are aligned with the Next Generation NCLEX.
We value our partnership with you, and ATI is committed to provide high quality products to help your students develop strong clinical judgment skills.
Thank you for taking time to view this webinar and we look forward to sharing additional updates with you in the future.
