Let’s talk about the NCLEX Conference Updates for 2022. The biggest topic, by far, was the NCLEX Next Generation exam that will be rolled out in April 2023. The main topics discussed were:
- 2021 Practice analysis
- Setting practice standards
- New NCLEX test plans for RN and PN coming out in December 2022
- NCLEX Next Gen coming out in April 2023
- Testing accommodations
- Computerized adaptive testing
- Special appearance by Keith RN
2021 Practice Analysis
The practice analysis is done every few years. You can review it here. There is an expert panel of nurses that compile a list of nursing activities. Then, newly licensed nurses are asked about what activities they perform on the job. The new nurses are asked the questions below about each activity:
If the activity is performed in your work setting, how often do you perform the activity?
How important is the activity regarding client safety and preventing complications?
How relevant is clinical judgement when performing the activity?
From the survey, the NCSBN (National Council State Board of Nursing – the people in charge of the NCLEX) learned that the typical entry level nurse works in a hospital caring for medical-surgical, critical care and ED patients. They also learned that new nurses care for an aging patient population in acute and critical conditions. They also learned that most new grad nurses will have a perceptor or do an internship residency for 13 weeks (I feel kinda shafted – I only got a 6 week training program for the neuro stepdown unit I started on).
Then that information is used to guide what will be on the NCLEX exam.
Setting Practice Standards
NCSBN also looked at the difficulty of the questions on the NCLEX called “setting the practice standards”. As of now, the standard “hardness” of a question will be the same until at least March 31, 2023. We will know in December of 2022 (when the new test plan comes out) if the “hardness” of the questions will stay the same or change. Because the overall pass rate of the NCLEX has declined (fewer people are passing the NCLEX), it probably won’t change or may actually become less difficult. I will let you know!
As I listened to the talk on how the passing standard is actually figured out, I realized it’s a pretty subjective process. A bunch of nurses (9 of them from various backgrounds) get together for a 3-day workshop and discuss how “likely” would a nursing student get the NCLEX-style question correct. They are trained on how to do it. Each nurse assigns a number on how hard or how easy they think the question is. Then the average is taken as a “hardness” # is assigned to each question. It’s a bit more complicated then that, but that’s the general idea.
New NCLEX test plans for RN and PN coming out in December 2022
The Test Plans tell us what will be on the NCLEX. Even though some people make this out to be a huge deal to try to scare you that the content on the NCLEX is changing, it’s probably not changing much. There will still be 8 sections you need to pass, and the basic nursing content will be the same.
Some preliminary information that we do know about the new test plans are:
- there will be slightly less questions on management of care (RN only)
- there will be slightly more questions on safety and infection control (RN only)
- a new clinical judgement model will be introduced (basically this is the nursing process but said in a different way)
- possible minor changes in some nursing content to know
- minimum number of questions is 85 and maximum number of questions will be 150
- discussion of the NCLEX Next Gen types of questions
In December, I will be going through the NCLEX test plans extensively to make sure the content lines up with what is in my popular book, NCLEX Nursing Nugget Pages. Then in January or February, the 2nd edition of the Nuggets will come out.
NCLEX Next Gen coming out in April 2023
This was by far the biggest topic at the NCLEX conference. The NCLEX Next Gen exam will be very similar to the current exam, except there will be 6-question case studies included on the test. The exam won’t all be case studies, but each student will get at least 3 case studies when they go to take the NCLEX. The rest of the questions will be 1-answer multiple choice or traditional select all that apply (SATA) questions. There are some major changes that are GREAT for students such as:
- partial credit for SATAs (you can pick some wrong answers and still get partial credit)
- lab value reference ranges will be provided (no more memorizing labs!)
- most of the case study questions will have partial credit
As a tutoring company, we will be prepared to teach how to answer the case study questions. But don’t fret! The nursing content isn’t changing much! And I think the case studies will be a much needed change. It just makes more sense to make decisions about client care based on more data, not just a tiny bit of data in a 1-answer multiple choice question.
Testing accommodations are basically the extras a student gets at the testing center, such as a private room, extra time or someone that reads the questions to you. I didn’t see any changes when it came to the discussion about testing accommodations. The highlights are:
- nursing regulatory boards determine and provide student eligibility for accommodations
- bring an official ID
- no phone or lock phone in a locker and not aloud to access during testing time
- no Apple watches or internet watches
- you can bring a hearing aid, medication auto-injector, medical device, inhaler, glucose tablets, cough drops without prior approval
- whatever you bring, it can’t make noise
Computerized Adaptive Testing (CAT)
CAT is an ongoing topic at the NCLEX conference. CAT exams are exams that are customized for an individual student. The difficulty of each question is tailored to the person taking it. If you get a question wrong, it will give you an “easier” question. If you get the question correct, it will give you a “harder” question.
So every time you answer a question, the computer re-estimates your ability based on all the previous questions you did. Then the computer selects a question that you have a 50/50 chance of getting correct. You will find each question challenging since it’s targeted to your ability. So basically every student only gets about 50% of their questions correct regardless if you pass or fail.
There is a passing line that the student will need to stay above to pass. If a student gets too many low level ability questions, then they won’t pass. But if the student can stay above the passing line, they will pass.
Special Appearance by Keith RN
Keith is a passionate educator and nurse that is trying to transform the classroom to better line up with what actually happens in the hospital. Sometimes nursing school is so wordy and theoretical that it’s seems so disconnected to the clinical setting. Nurses at work need to know the most important things to take care of their patients. In school, they bombard you with information that seems overwhelming and then you can’t figure out what to focus on. Keith had a funny word for it: infobesity. I’m sure he wasn’t the first to use this word, but it’s very accurate to nursing school. And it’s too bad nursing school has that reputation of being overwhelming.
Needless to say, I agreed with Keith’s overall message that as educators we need to prepare students better for the real world. He suggested case studies, worksheets, more group work, and prep work before coming to class. He had a lot of other good suggestions.
As a company that provides private tutoring, we definitely focus on simplifying topics and engaging students. The skills to prepare for the NCLEX are the same as being a safe and effective nurse in the clinical setting. You will use what you learn in tutoring to take care of real patients. And we keep what you need to know to the basics!