What is the Next Gen NCLEX?

In today's complex world of healthcare, nurses are often called upon to make decisions that require a great deal
of critical thinking. In this lesson, we will explore the Next Gen NCLEX exam to become licensed and how it
changed.

Why Are Americans Dying in Today's Hospitals?

Jennifer has just completed her orientation at a local hospital on a med-surg unit and is reporting
for her first duty shift after orientation. One of the nurses who normally is in charge has called in
sick and the other three nurses are also relatively new, so Jennifer has a choice between being in
charge and taking a light assignment, or taking a heavier assignment with more patients since
there is one less nurse. Jennifer chooses the heavier assignment, but then the phone in her pocket
rings, and she is informed that, in addition to her six currently assigned patients, she will now
receive a new admission who has several fractures from an auto accident and also an elevated
ETOH level.

Patient safety researchers at Johns Hopkins Hospital have calculated in a 2016 study that more
than 250,000 deaths per year in the U.S. alone are due to medical errors. Why is this so, and why
have these errors become the third-highest cause of death in this country? The Next Gen NCLEX
exam is one effort being made to correct this very troublesome problem.

What Is the Next Gen NCLEX?

The NCLEX, or National Council Licensure Examination, is a test that every nursing school
graduate must pass to become licensed in any state in the U.S. This test is put together by the
National Council of State Boards of Nursing, or NCSBN, whose goal is to create a test that truly
assesses the skill and ability of licensure candidates to meet the demands of this often challenging
job.

Every three years or so, the NCSBN evaluates the NCLEX based on research by collecting data from
entry-level nurses who are new to the acute care environment. The NCSBN strives to create a test
that reflects the reality of a hospital setting, where patients who are critically ill are often seen. The
Next Gen NCLEX is the NCSBN's most recent effort in this regard. It will focus on critical thinking
skills needed to make good decisions on the job, which result in effective patient care and the best
possible outcomes.
 Positive change in a new healthcare world

How Will the Next Gen NCLEX Be Different?

The Next Gen NCLEX is going to be significantly changed from current and past versions of the
NCLEX in many ways. This is not cause for alarm because it will still test the basic clinical knowledge
that student nurses learn in school. However, it will do this in a different way. The Next Gen NCLEX
will focus on the application of this knowledge in realistic clinical settings and will test the
candidate's ability to use good judgment and make sound nursing decisions. The new test will
measure the NCSBN Clinical Judgment Measurement Model, or NCJMM. The idea of clinical
judgment is not a new concept in NCLEX testing and has been addressed in earlier forms of the
exam, but in the Next Gen NCLEX, the goal is to measure this type of judgment with more precision
and in a more quantitative way.

New Types of Questions

The new types of questions found in the Next Gen NCLEX are based on findings from an NCSBN
2016 pilot study which indicated that, while clinical knowledge is essential, it is not always enough
to support good clinical judgment. Here, they are defining clinical judgment as ''the observable
outcome of decision-making and critical thinking.'' To answer the new types of questions well, the
candidate must be able to prioritize information given in the question and choose an action based
on what is most relevant. The question guides the candidate to assess the client's needs, form a
hypothesis, refine the hypothesis, and then evaluate the outcome.

The Next Gen NCLEX will have five basic question types, some of which are new, but some of which
are similar to those found in the current NCLEX. Partial credit can be given for the newer question
types that have multiple options for an answer. The five basic question types include:
 Extended multiple response - This type of question aims to be as complex as the real world and offers
the possibility of several correct responses. Since these questions are often challenging, partial credit may
be given.

Extended drag-and-drop - The candidate can move chosen options into an answer space.

Cloze (drop-down menu) - The candidate chooses an answer from a drop-down list. There may be more
than one drop-down list, and the question will be based upon a case study that is given with the question.

Matrix - The candidate is presented with a case scenario and relevant data, along with a matrix, or grid,
of answer choices. The candidate then checks the items in the matrix that will be applied as an answer.

Enhance HotSpot - The candidate is asked a question and given part of a client chart to read, and can
then highlight the words or phrases in the chart's data that answer the question.

Why Change the NCLEX?

The main reason for changing the NCLEX is because the demands of the nursing profession in the
acute care setting have become more complex than they used to be. Changes in the structure of
the healthcare system have created situations in which patients are discharged earlier and
admitted less frequently, with only the sickest patients remaining on the hospital floor for any
length of time. Nurse staffing may often be lean, and the new technologies that are used at the
bedside require extra training. Nurses often take a leadership type of role in which they must guide
teams of ancillary and supportive staff. More than ever, important decisions regarding patient care
rest upon the shoulders of the nurse. The new Next Gen NCLEX is designed to ask questions that
will truly assess the ability of a new nurse to function in today's world.

But, as a prospective new nurse, there is an important question: is this brave new world a good
thing, and should we really expect new nurses to accommodate themselves to it? Researchers are
trying to answer this pertinent question, and it may be true that, in addition to improved clinical
nursing judgment, policy changes within the healthcare system itself are needed to reduce medical
errors in today's hospitals. In the meantime, the Next Gen NCLEX may at least be able to help
today's nursing candidates get a true picture of the environment in which they will be working.

When Does the Next Gen NCLEX Go Live?

As of the year 2022, the proposed date for the Next Gen NCLEX to go live is April of 2023. Some of
the test takers will be selected to participate in a Special Research Section that will follow the
regular exam and not be scored as part of the NCLEX. It will instead be used for research purposes
only.

Lesson Summary
The NCLEX, or National Council Licensure Examination, is the test that a prospective nurse must
pass in order to become licensed. It is sponsored by the National Council of State Boards of
Nursing, or NCSBN. The Next Gen NCLEX is the NCSBN's most recent proposed version of the
NCLEX and is slated to go live in April of 2023.

The Next Gen NCLEX is designed to ask exam questions that are more relevant to today's complex
nursing practice. These questions measure the Clinical Judgment Measurement Model, or
NCJMM. Their goal is to evaluate a candidate's ability to make effective clinical decisions based on
sound nursing judgment.

The Next Gen NCLEX will include new types of questions that require the testing candidate to
eliminate information that is not relevant and get to the heart of the problem being presented.
Partial scoring will be allowed on many of these questions.
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