The Next Generation NCLEX Exam is Here: What it Means for You and Your Nursing Students
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Since 1982, the National Council Licensure Examination (NCLEX) has been the standard for licensing nurses not just in the United States, but in Canada and Australia as well. The purpose of this exam is to assess a nursing student's ability to think critically and exercise clinical judgment to provide the highest level of patient care. For RN students, the NCLEX has long been a source of anxiety—but (as you know) the right study plan and guidance can prepare students for success.
Beginning in 2023, however, the NCLEX that you've gotten to know so well over the years is changing. Specifically, the Next Generation NCLEX (NGN) exam was implemented on April 1, 2023.
Of course, this means changes to how you as an educator prepare your students for what's sure to be one of the most important exams of their lives. While you have been aware of these changes, it’s possible some of your students may not be. Read on to learn a bit more about the NGN and how it may impact your students.
Why has the NCLEX Exam Changed?
The National Council of States Boards of Nursing (NCSBN) is responsible for creating and updating the NCLEX exam to ensure that its content best reflects current nursing practices and accurately assesses nursing students' knowledge. Part of how they do this is by surveying approximately 12,000 recently licensed nurses about various topics that appear on the exam. These surveys are conducted every three years and provide the NCSBN with valuable information needed to improve the exam itself.
Over the years, survey responses and other research has suggested that the current format of the NCLEX exam may not provide the most accurate or realistic assessment of a student's clinical judgment skills. By making some carefully calculated changes to the exam itself, the NCSBN aims to better evaluate a student's clinical judgment and ensure that they are prepared to provide competent and safe care once they begin working in the real world.
What's Changed, Exactly?
While some of the format and the types of questions presented in the exam , one important thing remains the same: When nursing students truly know and understand the information, the format of the test doesn't matter.
As an educator, of course, you should still be prepared for the specific format changes to expect with the NGN. These include:
- New item types - Extended Drag & Drop, Matrix, Cloze, Highlight, and Select All That Apply (SATA).
- New question formats - Split screen questions with cases on the left side of the screen and question items on the right.
- New clinical judgment item updates - Scenarios will have six items associated with each case, with 2-5 cases requiring a total of 12-30 clinical judgment items in each test.
- Matrix item answers - Some items may have one or more than one possible answer, with circle selection buttons indicating a single acceptable answer and squares indicating multiple answers.
- Greater focus on case studies - More case studies will be incorporated into the test to simulate real-world situations.
- Scoring changes - New polytomous model means that some items will be eligible for partial credit, depending on how the student answers.
How Educators Can Better Prepare Students
Though the test has undergone major format changes, the underlying concepts of the NGN exam remain the same. Still, there are some practical steps instructors can take to provide a better RN education and enhanced preparation for the NGN exam.
Teach the NCSBN Clinical Judgment Model
First, educators should renew their focus on teaching the NCSBN Clinical Judgment Model. Not only are many items on the NGN tailored towards this, but following this model will serve future RNs well in the workplace. Specifically, educators should focus on preparing students to separate relevant information from irrelevant information and form/refine hypotheses based on patient cues.
Pediatric Nursing Care: A Concept-Based Approach, Second Edition, for example, includes updates from the Healthy People 2030 initiative throughout the text as well as content related to the AACN Essentials update of 2021.
This resource supports success in the NGN through expanded case studies focused on clinical decision making as well.
Because the NGN exam incorporates significantly more case studies, educators and students would also be well served to practice with case studies in the classroom as often as possible. Case studies provide real-world scenarios that students could easily encounter in their careers preparing them for the realities of the work.
Professional Nursing Concepts: Competencies for Quality Leadership, Fifth Edition is an ideal text for teaching students how to transition from the classroom to practice. For example, this text includes case studies throughout with practice questions closing out each chapter, new Clinical Reasoning and Judgment, Collaborative Learning, and role play activities. The text is designed to encourage students to interact with the content in more dynamic ways either as individuals or in collaborative groups.
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Focus on Application in Clinical Settings, Clinical Reasoning and Critical Thinking
Overall, RN educators can best prepare students by shifting from decontextualized/abstract knowledge to its application in clinical settings, as well as emphasizing clinical reasoning and critical thinking in their lesson planning.
Leadership in Nursing Practice: The Intersection of Innovation and Teamwork in Healthcare Systems, Fourth Edition includes Case Scenarios, Reflective Questions, and Critical Thoughts. These tools serve as examples that are both relevant to practice and experiential in nature, challenging students to take a more active role in their professional development. Additionally, review questions round out each chapter, tying core concepts back to national licensure exam categories and American Organization of Nurse Executives (AONE) competencies.
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Likewise, instructors can work individually with students to identify their weaknesses and focus on those areas in the months leading up to the exam.
The nursing field is dynamic, so it only makes sense that the NCSBN must occasionally make changes to licensing exams to ensure that today's nurses are prepared to provide the best care. With a little guidance from educators like you, the next class of RNs can pass the NGN with flying colors.
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