Bruin Brief 2022-10-28 NCLEX past, present, and future
- Cynthia James
From Academic Affairs
October 28th 2022
NCLEX past, present, and future
The NCLEX exam has changed before, and it is changing again. In April 2023 the Next Generation NCLEX (NGN) will be offered to students. The National Council of State Boards of Nursing (NCSBN), the organization that develops the test, expects to see a drop in pass rates. Last time they changed the exam (1994) there was a 10% decrease in NCLEX pass rates nationally, and it took two years for the pass rates to return to stability (J. Schwartz, personal communication, 10/18/2022).
This Bruin Brief explains what is ahead for NCLEX testing changes, how we are preparing faculty and students for this change, and where the UCLA SON is current performing in terms of NCLEX pass rates for BS and MECN graduates. Our goal, as always, is to maintain excellence in our nursing program.
The Change Ahead: How the Clinical Judgement Model informs the new NGN test questions
The new exam focuses on clinical judgment and asks students questions in the Level 3 area, highlighted in the figure. The questions ask students to consider What Matters Most? in a patient situation, What could it mean? Where do I start? What can I do? What will I do? And Did it make a difference?
Jason Schwartz, the NCSBN Director of Outreach, recently shared how to prepare new nurses to take the NGN. “We used to start slowly, and the first few quarters would feature exam questions based on fact recall, or perhaps a single clinical action. That was a luxury. And it can’t continue. To be prepared, students need application-level questions beginning in Fundamentals and in every other course after that.”
He suggested that every faculty member download the case study featured in the NGN Newsletter (Spring 2020 downloadable here, or by clicking the icon below). Of all the newsletters NGN has published, he emphasized that this is most important (you can view them all, or subscribe at the webpage).
Key features NGN Case Study formats include—
A scenario that provides initial information to the test-taker and can evolve to include new information as the NGN Case Study unfolds.
Six questions that correspond to the six “layer three” elements of the clinical judgment model.
A variety of item types, including new formats being introduced specifically for the NGN.
If you are wondering how the clinical judgment model will change your teaching approach, then talk with the Prelicensure Faculty at the regular program meeting, download the NGN News, subscribe to ongoing NGN newsletters, talk with our Kaplan representative, or speak to anyone on the NCLEX Taskforce led by Dr. Bralock.
Progress to Date: UCLA SON is already on board
Thanks to Anita Bralock and colleagues in the prelicensure program, including Emma Cuenca and Barbara Demman, we already know about NGN changes and are ready for change. Dr. Bralock led prelicensure lead faculty and the NCLEX Taskforce through MountainMeasures feedback on student exam results. They have talked about how to work effectively with the Kaplan program in every course. The attached flier was sent by Dr. Bralock to faculty, along with her own experience over the summer with NGN-style questions. She wrote: “we had our first maternity exam today. The exam had 65 questions with mainly multiple choice. We also had multiple responses, fill in the blank and 5 fetal monitor strips that they needed to decipher. After the exam we had student activities where we completed thinking exercises to improve their clinical judgement. Developing Clinical Judgement is an Elsevier book that can be added to your Evolve resources so that you have an electronic copy.” Thanks for those tips and examples!
How did BS and MECN graduates perform on the NCLEX this year?
The School is notified quarterly about NCLEX test-takers and pass rates. Below is the report from Q3 (July-September). This period of time represents the bulk of our test-takers, but it does not tell the whole story. Early in 2023 we will receive results for the entire 2022 year.
The good news: Both BS and MECN students scores have begun to recover from the nationally-noted COVID dip in pass rates. Also noteworthy: Our scores are equivalent (MECN) or better (BS) than the national mean scores during 2021.
National NCLEX pass rate patterns over time
In 2021, the pass rate for first-time test-takers with a U.S. education was 82.5% (NCSBN data). Below you will see a breakdown by year and by quarter.
Charting our course to the future
We are moving forward according to plan, and preparing graduates for NGN-style questions. The NCLEX taskforce is working to integrate clinical judgment into clinical experiences so that both theory and clinical prepare students for the NGN. Most sweeping of all are the changes that synchronize the AACN Essentials with the NGN. Rather than two distinct initiatives, both the Essentials and the NGN are bedrock examples of how nursing as a profession enacts our social compact to competently care for the health and safety of the public. The emphasis on competency-based learning and outcomes evaluations is the same, with student competence measured in relation to program outcome competencies. Both the Essentials and the NGN are asking nurses to demonstrate that they can DO safe nursing practice.
BONUS: The eValue update of the Week
More faculty than ever have made the first step toward opening eValue and populating their faculty profile page. This week we jumped from 25% to 33% faculty completion. The goal is 100% faculty participation by October 31st. The reason we’re populating these faculty profiles is so that the surveys we complete for the BRN and CCNE (and others) can be done easily and quickly, without bothering you over and over for the same information. Please complete your eValue assignment today! Instructions are in the September 9th Bruin Brief on the http://www.sonnet.ucla.edu intranet (link is here).
Double Bonus: Recognizing two Faculty as Shining Stars!
Student advising is a big responsibility, made easier with eValue. See below for the outstanding performance of @Cuenca, Emma L. and @Macey, Paul. Both have met with their advisees and charted those meetings in eValue. Thank you Emma and Paul!
Significant Contributors:
Paul Macey, Director of Evaluation
Brenda Yeung, Academic Affairs Policy Analyst
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Lauren Clark
Professor and Shapiro Family Endowed Chair in Developmental Disability Studies
Associate Dean, Academic Programs
Office: (310) 267-5923
Mobile: (801) 503-4755
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