By Susan Sportsman, PhD, RN, ANEF, FAAN
On September 22, 2022, I participated in the National Council of State Boards of Nursing’s 2022 NCSBN NCLEX Conference and found all of the presentations helpful in understanding how to prepare both RN and PN students for the Next Generation NCLEX (NGN), coming in April 2023. As we move closer to the initial implementation of the NGN, the content of these presentations helped to clarify various components of the 2023 exam, including information regarding the 2021 Practice Analysis, setting the “cut score” standard, exam administration, and the scoring of the NCLEX. Because this meeting covered a wide range of topics, I am including points that I thought would be helpful during the fall and winter as you continue preparing students in the first cohort to take the NGN.
Clinical Judgment to become an Integrative Process. When the NCSBN Board of Directors meets in December 2022, clinical judgment is set to become one of the Integrative Processes in the NCLEX Test Design, along with nursing process, communication and documentation, teaching-learning, and culture and spirituality. Designating clinical judgment as one of the processes in the Test Design that nurses integrate in all practice scenarios emphasizes the importance for nurse educators to integrate clinical judgment into all student teaching-learning activities and evaluation processes, including examinations.
Importance of the Practice Analysis. The 2021 Practice Analysis, a job analysis of nurses in their first 6 months of practice, began with the development of activity statements describing the practice of a novice nurse. These statements were integrated into a survey sent to 24,000 new nurses and nurses who supervise them. For each activity in the survey, the respondents were asked to evaluate the following, according to a Likert scale:
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- How often was each activity performed? (Evaluation of frequency)
- How important is the activity? (Evaluation of Safety)
- How relevant is clinical judgment to the accomplishment of the activity? (Relevance)
The results of the survey identified the frequency, importance, and relevance of each of the activities. The survey findings identified activity statements that best described the practice of new graduates. These activity statements will then be used to determine the percentage of test items in each NCLEX Test Plan category and the distribution of content across the April 2023 NCLEX. In this way, the activity statements and the test plan provide nursing educators with a road map of competencies important to the practice of the new nurse.
To read more about the 2021 Strategic Practice Analysis, go here and here.
Changes in the Test Plan. In December 2022, the NCSBN Board of Directors will approve the NCLEX Test Plan which is to guide the NCLEX first offered in April. 2023. The proposed NCLEX-RN Test Plan is scheduled to change only slightly from previous test plans. The percentage of test items in the Management of Care category will decrease slightly and both Safety and Infection Control and Pharmacology will increase slightly. There are no changes to the percentage of test items in each category for the NCLEX-PN. The NCSBN will announce the official approval of these Test Plans via email and social media.
After the announcement of the official Test Plan for 2023, it will be available on the NCSBN website early in 2023. The new test plan will include:
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- A detailed definition of Clinical Judgment
- Components of a Case Study
- Explanation of the cognitive skills in the Clinical Judgement Measurement Model (recognize cues, analyze cues, prioritize hypotheses, generate solutions, take actions, and evaluate outcomes)
- Examples of new NGN item types
- Examples of Case Scenarios and Stand-alone items
- An updated NCLEX Tutorial
I highly recommend that you share this information with your students as soon as it is available and incorporate it into your learning activities and evaluation processes.
Some general information:
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- All medications will be described by generic terms. A question may ask about a classification of a drug, rather than an individual drug.
- Specific lab findings will also include reference ranges.
Nurse educators should use these same approaches in teaching-learning activities and in examinations. The important thing to keep in mind is to emphasize for students how this information should be used to in the care of the patient.
The 2022 NCSBN NCLEX Conference also outlined the scoring for the Next Generation NCLEX, which I am sure all of us are eager to understand. This will be the subject of next month’s blog post.
Until then, continue to emphasize clinical judgment in all teaching-learning activities and in examinations to prepare students for the Next Generation NCLEX and clinical practice. April 2023 will be here before we know it!
References
NCSBN (2022) Overview of the 2021 Practice Analysis. Next Generation News. Summer. https://www.ncsbn.org/public-files/NGN_Summer22_ENG_FINAL.pdf
NCSBN (2022) Overview of the 2021 Practice Analysis. Next Generation News. Spring. https://www.ncsbn.org/public-files/NGN_Spring22_English.pdf