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NGN Update: What you need to know now
By Susan Sportsman, PhD, RN, ANEF, FAAN
The Next Generation NCLEX (NGN) has been “top of mind” for the Nursing Education community for at least the last two years. Last month Elsevier Education offered a three-hour workshop, highlighting Dr. Phil Dickison, Chief Operating Officer of the National Council of State Board of Nursing (NCSBN), and two nurse educators, Dr. Linda Silvestri and Dr. Donna Ignatavicius. This webinar focused on the most up-to-date information about the NGN.
In his presentation, Dr. Dickison gave some important information of which we should all be aware as we continue our journey toward preparing our students for the NGN. Here are several points that I felt were particularly helpful.
The introduction of the NGN into the NCLEX-RN and NCLEX-PN testing of new graduates will DEFINITELY begin with the April 2023 cycle of testing .
At least 680,000 test takers opened the research component in the NCLEX-RN Exam and approximately 340,000 test takers took an average of 15 research items that were not counted in their score. Since January of 2020, more than 1000 questions have been tested. Finally, the NCSBN is confident that the technology works!
Three types of test questions will be a part of the NGN NCLEX:
- Case Studies: involve a real-world nursing scenario accompanied by multiple (typically 18) test items. Case studies use up to six test items, which target multiple cognitive elements of the Clinical Judgment Measurement Model (recognize cues, analyze cues, prioritize hypotheses, generate solutions, take action, evaluate outcomes), using a scenario.
- Standalone Items: Individual items that are not part of a case study, which may target one or more of the Clinical Judgement Measurement Model elements.
- Multiple Choice/Multiple Response: test items that require students to apply clinical knowledge, using testing approaches currently on the NCLEX.
The Case studies and standalone items will include several new item types introduced specifically for the NGN.
Many of these new item types are familiar to those who have been following the updates provided by the NCSBN, including highlighting, Cloze (Pull-Down Menu), Matrix/Grid, and Extended Multiple Response, Extended Drag & Drop. Examples can be found here .
Two newer item types to be used with the Case Studies and the Standalone items include the Bow-tie item (so named because it looks like a bow tie) and the Trend item.
Like all the NGN-type items, the left side of the screen in these two types of items include clinical data. In the Bow-tie item , the left side of the screen may include one or more tabs. Possible tabs include Nurses’ Notes, History and Physical, Laboratory Results, Vital Signs, Admission Notes, Intake and Output, Progress Notes, Medications, Diagnostic Results, and Flow Sheets. Possible tabs in Trend items include Nurses’ Notes, History & Physical, Laboratory Results, Vital Signs, Admission Notes, Intake and Output, Progress notes, Medications, Diagnostic Results, and Flow Sheets.
- Bow-tie items address all six steps of the Clinical Judgment Measurement Model (CJMM) in one item. The test-take must read the data outlined on the left side of the testing screen and then determine 1) if findings are normal or abnormal, 2) possible complications or medical conditions being experienced by the client, and 3) possible solutions to the problem. The Bow-tie question requires the test-taker to take this identification and analysis of the cues and generation of possible solutions to answer the question. This question type asks what the most likely cause of the client’s issue is (Prioritize Hypotheses), and the most appropriate action to take or the outcomes to evaluate.
- Trend items , which are individual items, require information gathered over a period of time to answer the questions. Trend items address multiple steps of Layer 3 of the NCJMM, but do not follow the six-item sequence like case studies do.
Next Generation NCLEX NEWS ® SPRING 2021 Next Generation NCLEX®: Stand-alone Items provides clear examples of the content and format of these two types of NGN questions.
Dr. Dickison spoke about the differences in the current NCLEX and NGN version, which is outlined in the chart below.
Comparison of Current and NGN NCLEX
In subsequent blog posts we will talk more about ways to develop questions to help students learn to use clinical judgement in faculty-made tests, as well in teaching learning activities, to prepare for the NCLEX-NGN beginning in April 2023. However, I hope this overview will start your creative juices flowing as you consider engaging ways to implement the Clinical Judgment Measurement Mode in your own classrooms.
Let us hear from you about your ideas!
Dickison, P. (2021) Next Generation NCLEX: Update. https://www.ncsbn.org/2021_MYM_pdickison_NGN.pdf . Accessed April 2021.
______ (2021) Next Generation NCLEX News: Standalone Items. https://www.ncsbn.org/15800.htm . Accessed April 2021.
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Next Generation NCLEX: Case Studies 1-2. Nurse Plus Academy is excited to offer a new Next-Generation NCLEX (NGN) practice test to help NCLEX applicants prepare for the upcoming changes to the exam. The NGN is designed to better measure a candidate's clinical judgment and will include innovative item types such as extended multiple response ...
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Next-Generation NCLEX (NGN)-Style Case Studies for Nursing Research Unfolding Case Study 1: Reading Nursing Research. Pesut, B., Thorne, S., Schiller, C. J., Greig, M., & Roussel, J. (2020). The rocks and hard places of MAiD: A qualitative study of nursing practice in the context of legislated assisted death.
While it's true that the NGN features various types of questions, the principles of clinical judgement apply across them all. By mastering how to analyze and interpret case studies, you will be better equipped to answer any type of question the NGN presents, be it multiple-choice, select-all-that-apply, or hotspot questions.
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The case study is designed to provide data for the student to utilize in applying the clinical judgment measurement model. The model identifies six cognitive processes a nursing graduate must master. These include recognizing cues, analyzing cues, prioritizing hypotheses, generating solutions, taking action, and evaluating outcomes.
Before you attempt writing a case study, you need to understand how to design it. To do that, you need to be familiar with Layer 3 of the NCSBN's Clinical Judgment Measurement Model. Layer 3 illustrates the 6-step process that a nurse goes through in each client encounter. (See the numbered graphic below that depicts the 6 steps.)
Clinical judgment is defined as the observed outcome of critical thinking and decision-making. It is an iterative process that uses nursing knowledge to observe and assess presenting situations, identify a prioritized client concern, and generate the best possible evidence-based solutions in order to deliver safe client care. Focus is solely on.
Client/Nurse Interaction. The six questions in the case study should focus on the application of one of the cognitive skills highlighted in the Clinical Judgment Measurement Model (CJMM). Silvestri (2020) identifies questions that test-writers (and test-takers) ask themselves to understand each of the six cognitive skills.
The Next Generation NCLEX ® (NGN) is here! All RN and PN students are now required to take the NGN—a new approach to the licensure exam that focuses on clinical judgment to get you thinking like a nurse before you enter the workforce. The NGN might seem like a big change, but Elsevier has you covered—learn more about the details of the ...
NGN Test Design Design Specification NCLEX Today NGN Minimum Length Exam NGN Maximum Length Exam Time Allowed 5 hours 5 hours 5 hours Case Studies N/A 3 (i.e., 18 items) 3 (i.e., 18 items) Clinical Judgment Standalones N/A 0 Approx. 7 * Knowledge Items 60-130 52 Approx. 110 Total Scored Items 60-130 70 135 Unscored (Pretest) Items 15 15 15
White Paper Using Case Studies to Develop Clinical Judgment and Ensure Next eneration NCLEX ® NGN) Success 2 Background In 2010, the results of a large study of nursing education in the United States were summarized in Educating Nurses: A Call for Radical Transformation (Benner, et al., 2010).One of the key findings was that nurses entering practice do not
This article highlights unique challenges adjuncts may face in learning and implementing significant changes in teaching and learning. It presents a way of applying the model known as the NGN Clinical Judgment Slide technique. It also provides 24 innovative approaches to encourage more profound, meaningful conversations in the clinical unit.
1) make care safer by reducing harm caused in the delivery of care. 2) ensure that each individual and family is engaged in their care. 3) promote effective communication and coordination of care. 4) promote the most effective prevention and treatment practices for the leading causes of mortality. 5) work with communities to promote wide use of ...
The introduction of the NGN into the NCLEX-RN and NCLEX-PN testing of new graduates will DEFINITELY begin with the April 2023 cycle of testing. At least 680,000 test takers opened the research component in the NCLEX-RN Exam and approximately 340,000 test takers took an average of 15 research items that were not counted in their score.
The Next Generation NCLEX (NGN) has led to increased classroom utilization of NGN-style case studies to improve clinical judgment skills; however, these case study topics are often standardized cases developed by NCLEX preparation products or are developed at the discretion of didactic nursing faculty and may not be entirely reflective of the ...
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The Next Generation NCLEX (NGN) has led to increased classroom utilization of NGN-style case studies to improve clinical judgment skills; however, these case study topics are often standardized cases developed by NCLEX preparation products or are developed at the discretion of didactic nursing faculty and may not be entirely reflective of the diverse patient populations, acuity, and evolving ...