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A refresher: What You Need to Know About the Next Generation NCLEX

Oct 2, 2023, 11:43 AM
<4-min. read> Are you unfamiliar with the NGN? This article gives you a start to understanding how it was developed.

UNDERSTANDING THE FOUNDATION OF THE NGN'S DEVELOPMENT

Is the Next Generation NCLEX (NGN) a new concept to you? If you're not familiar with it, it is a fundamentally different exam than the NCLEX you took after graduating from nursing school.

To help you understand why the National Council of State Boards of Nursing (NCSBN) changed the test, we've put together this short summary article with information about how it was developed. Read on for an explanation of the 8 evidence-based steps that the NCSBN’s expert team of psychometricians and researchers followed to create the new NCLEX:

1) DEVELOP THE CLINICAL JUDGMENT MODELNCSBN's CLINICAL JUDGMENT MEASUREMENT MODEL

NCSBN developed a Clinical Judgment Measurement Model (see above) consisting of 5 interacting layers that illustrate the complex process of clinical judgment, including the context in which decisions are made.

2) CREATE ITEM PROTOTYPES

New item types are what set the new version of the exam apart from the version you took as a graduate. That version focused on assessing only nursing knowledge. The new exam includes item types that measure clinical judgment and are much more complex than, say, typical multiple-response questions. Setting these unique new item types apart even more is that they require different scoring methodologies — scoring that now includes penalties for answers indicating a lack of clinical judgment.

3) TEST ITEM USABILITY

To ensure the new item types represented real-life clinical judgment scenarios, students, nurses, and educators reviewed each one. It was a long process with much iteration and revision. But the results are questions that — according to students who have taken the new exam — replicate the critical-thinking process they experienced in clinical settings.

4) COLLECT ITEM DATA

Before the NGN launched in April 2023, select students who took the NCLEX were offered the option to answer a “Special Research Section” added to the exam that included the new item types. Students' responses to the questions in this section didn't impact their scores but did provide valuable insight into question fidelity.

5) RESEARCH MEASUREMENT

Psychometricians received hundreds of thousands of results from students' answers to the “Special Research Section.” Using ongoing analysis of this information, they determined which item types accurately measured clinical judgment and nursing competence.

6) BUILD TECHNOLOGY

The NCSBN recognized, early on, that the computer technology it used to assess students' answers on the NCLEX would not work for the new item types. Therefore, as one set of researchers worked to fine-tune the evolving new item types, others at the organization focused on building a more complex computer system to assess and score them.

7) PERFORM ALPHA/BETA TESTS

Psychometricians who helped develop the new item types were keen to evaluate them on multiple levels. Thus, the NCSBN scrutinized every item type using different test-takers to identify the questions that provided the highest accuracy of these individuals' clinical judgment.

8) LAUNCH NEW NCLEX-RN

After 3-4 long years — that included complications from the pandemic — the original operational phase of testing and building item types ended. The new version of the NCLEX launched April 1, 2023.


What does the new NCLEX mean for you and your students?Faculty member talking with student.

The Next Generation NCLEX means better evaluation of graduates’ readiness for the challenges of real-life nursing practice.

You can help your students prepare for it by taking advantage of products that help students develop their clinical judgment and sharpen this critical skill.

ATI offers a variety of tools to support these crucial objectives:

THE NCLEX EXPERIENCE

Some of the items on the new NCLEX are unlike those on the previous version of the exam. ATI’s NCLEX Experience helps acclimate students to these new item types, which measure, quantify, and test their clinical judgment skills.

The NCLEX Experience comprises an engaging tutorial and mini quiz to provide familiarity and build confidence in successfully answering the item types on the new NCLEX.

NURSE'S TOUCH, THE COMMUNICATOR 2.0

Developing effective communication skills goes hand-in-hand with developing sound clinical judgment.

Developing effective communication skills goes hand-in-hand with developing sound clinical judgment. One research study1 reported that, “Collaborative dialogue between students, educators, and clinical mentors as role models during nurse-patient interaction is a powerful learning tool in facilitating clinical judgment.”

ATI’s Nurse's Touch, The Communicator 2.0, uses simulation to help students develop these essential skills. Students interact with virtual humans in repeated engagements, so they can learn and practice communication techniques for those key conversations they will experience as nurses.

REAL LIFE CLINICAL REASONING SCENARIOS

ATI’s Real Life Clinical Reasoning Scenarios addresses vital issues.

Nurses who lack clinical reasoning skills make poorer nursing judgments: They have difficulty differentiating between acute problems and those needing immediate attention. These nurses often fail to detect impending patient deterioration. In addition, they often make inappropriate judgments, such as misidentifying a situation or using faulty logic. ATI’s Real Life Clinical Reasoning Scenarios is specifically aimed at addressing these vital issues.

The product’s computer-based simulations are designed to develop clinical reasoning, while its live-action videos create “emotional fidelity,” engaging students’ mental and emotional abilities. Its “rational mode” option provides immediate feedback to students after they make a decision. Students gain exposure to key clinical situations; learn from their errors and the consequences to improve future interactions; and advance their knowledge. Students are able to repeat scenarios until they achieve mastery.

To learn more about these new products, contact your account representative or a member of the ATI team.


Item types on the new NCLEXStudent uses computer at desk.

The Next Generation NCLEX test uses a complex mix of item types that require nursing students to demonstrate their clinical judgment skills.

Item types include:

  • Cloze
  • Extended drag-and-drop
  • Enhanced hot spot
  • Extended multiple response
  • Matrix/grid
  • Bowtie.
Read specific details about each one in the ATI NGN Resource Center.

1 Anna C. van Graan, Martha J.S. Williams, Magdalena P. Koen Professional Nurses’ Understanding of Clinical Judgment: A Contextual Inquiry Health SA Gesondheid, Volume 21, December 2016, PP. 280-293