The NCLEX exam, short for National Council Licensure Examination, is the licensing exam that nurse graduates must pass in order to legally practice nursing in the United States, Canada, and Australia.
Practical (or vocational) nurse graduates must pass the NCLEX-PN exam, and registered nurse graduates must pass the NCLEX-RN exam.
If you’re a nursing student who expects to graduate in the spring of 2023 or later, there are huge changes taking place with the NCLEX exam that you’ll want to know about.
Next Generation NCLEX (NGN)
The National Council of State Boards of Nursing (NCSBN) plans to release a new format of NCLEX called the Next Generation NCLEX, or NGN for short.
When Will The Next Generation NCLEX Go Into Effect?
The NCSBN plans to release the new Next Generation NCLEX format on April 1, 2023. So, unless the release date changes, those of you graduating in spring 2023 or later will likely get the new format.
What is the Next Generation NCLEX? What’s Changing?
All exam details are subject to change before the actual release date. However, one of the big changes that you’ll find on the Next Generation NCLEX is a shift toward case studies (also called scenarios) to help assess the critical thinking ability of test takers.
What’s a case study? It’s a created scenario that could happen in the real world of nursing that assesses the test taker’s ability to handle a particular nursing situation. The test taker is given information about a patient, their diagnosis, current assessment findings, medications, lab results, and a presenting problem.
Based on this information, the testing candidate will be asked several questions on how the nurse would response or deal with the situation. This type of question requires much more critical thinking and nursing knowledge, and it assess whether the person will be able to deliver good, quality patient care.
There will be approximately three case studies with 6 questions each, for a total of 18 items [3], in addition to other types of questions.
There will also be five new item types on the Next Generation NCLEX, including the following:
Extended Multiple Response – Although multiple response items such as SATA questions are on the current NCLEX, “Extended Multiple Response” will expand on the number of options for each question.
Extended Drag and Drop – These question types require you to drag a response into one of the blank answer spaces, and test takers will now have to determine whether they should use some or all of the options available.
Cloze (Drop-Down) – these are the drop-down options that allow you to select a correct response, and there can now be multiple drop-down boxes in a Cloze question type.
Enhanced Hot Spot – this enhanced item type allows you to select (or highlight) the relevant words or phrases from a sample medical record that correspond to the question.
Matrix / Grid – this item type features rows and columns with options that the candidate must select.
Next Generation NCLEX Scoring Changes
If any of that NCLEX news makes you nervous, I have some good news: the Next Generation NCLEX is also changing their scoring model to a polytomous scoring model, which means that you can now get partial credit on some questions with multiple inputs. This is different from the regular NCLEX model, which marked questions as “full credit” or “no credit” only.
And yes, this does include those dreaded “select all that apply” (SATA) questions!
The Next Generation NCLEX will use three different scoring models, depending on the question type [2]:
0/1 scoring means you earn a point for each correct option selected, and zero points when you select an incorrect option. The points are then added together for a total question score. This scoring type is used on questions such as multiple choice, matrix multiple choice, multiple response where you select a specified number of answers (select N), drop-down cloze, drop-down table, and bowtie questions.
+/- scoring means that you can earn a point when you select a correct option, but lose a point when you select an incorrect option. This method is used with select all that apply multiple response questions, matrix multiple response, and MR grouping questions.
Rationale scoring means that you only earn points when you select a response that reflects a proper understanding of the rationale of the question. In this format, you will select the paired options that logically follow (Example: A leads to B). Both options must be selected correctly to earn a point.
How Many Questions are on the Next Generation NCLEX?
Each candidate will receive a minimum of 85 and a maximum of 150 questions on the exam. However, 15 of those questions are pretest questions that are not scored, so test takers can expect between 70-135 questions that are actually scored on the Next Generation NCLEX exam [3].
The exact number of questions a test taker will receive varies because the NCLEX uses Computerized Adaptive Testing (CAT), which continues to provide questions of different difficulty levels based on the test taker’s previous responses.
The test taker will continue to receive questions until the computer can determine with 95% confidence that the individual either passed or failed the exam. The exam will also stop once time is up or the person reaches the maximum number of questions (135).
How Long Do I Have to Complete the Next Generation NCLEX Exam?
You will have 5 hours to complete the Next Generation NCLEX exam.
Can You Use a Calculator on NCLEX?
NCLEX currently allows you to use a provided calculator on the test screen, and this will likely continue for the Next Generation NCLEX.
Don’t Be Intimidated by the Next Generation NCLEX (NGN)
I know that some of you are stressed out about this new NCLEX format, but I don’t think you should worry about it at all.
Unlike the meme below, the NCSBN is not some evil organization with an agenda to torture nursing students with the fear of forever failing NCLEX. Instead, these individuals are professionals who want to ensure that you’re equipped with the proper knowledge so that you can offer great care and succeed in practice.
They have a very strict process whereby nursing instructors actually develop questions. Then those questions are peer-reviewed by actual nurses in practice, and they even pretest questions and gather statistics to ensure that the exam is accurate and ready to administer.
So this isn’t something slapped together on a whim by people who know nothing about the nursing profession. It is a long, reviewed process that is continually improved based on feedback and statistics.
How Should Nursing Students Prepare for the Next Generation NCLEX (NGN)?
So how should you prepare for the Next Generation NCLEX right now as a nursing student? First, so many people are asking, “What’s changing with NCLEX?” It’s great to know what’s coming and how the questions will be formatted, and I do think practicing some questions in similar NCLEX format can be helpful.
(For the record, the NCSBN even offers a mock NCLEX exam with actual questions from previous exams that you can take at NCLEX.com for a fee if you want to practice before the actual test.)
However, I wouldn’t spend too much time stressing about the new NCLEX format changes.
If you really want to succeed on NCLEX, you need to ask this question, ”What is NOT going to change about NCLEX?” And what’s not changing is the fact that they are trying to ensure that you know enough about nursing to think critically and make the right clinical decisions so that you can provide safe and effective patient care.
So your study strategy needs to have that focus from day one. How do you do that? I would still offer the same advice that I offered in my recent NCLEX Study Plan video.
1. Start studying as early as possible. I started studying hard during the break before my last semester.
2. Prioritize your weak areas. I talked about how you can assess your strengths and weaknesses through software and so forth.
3. Practice many NCLEX-style questions. I would practice 90-100 questions almost every day.
4. Go back and review questions and topics you keep missing. Look at the pathophysiology of diseases on questions you missed. Look up medications and their mechanism of action, and so forth. Go back and study those important details.
5. Switch between review lectures, textbooks, and notes when you are not practicing questions to help you understand the content in different ways. Your brain will appreciate the switch to different studying formats. In other words, when you are tired of reading, watch a lecture that covers similar topics.
In my review lectures, I always try to help you to understand not just the way something is done, but the “why” something is done. I spend time trying to explain the patho and rationale behind things so that you’ll understand it more deeply and be able to think critically on exams and in real-life nursing practice.
That’s the key to really passing NCLEX. They want you to know enough about nursing to think critically and make the right clinical decisions.
And if you put in the time to understanding those things, it doesn’t matter whether you get a drag and drop, hot spot question, select all that apply, or whatever. You’ll have the knowledge in your head, and you will be able to sift through and choose the correct option(s).
Final Thoughts on Next Generation NCLEX
In conclusion, don’t waste time worrying about the changes coming in Next Generation NCLEX. Instead, stay the course and put in the time studying and practicing questions, and you’re going to do great!
Even if you do fail your first time around, you have the opportunity to take it again, so go into the exam with confidence!
References:
1. https://www.ncsbn.org/11436.htm