Everything to Know About the Next Generation NCLEX

Nursing, especially since the Covid times, has been under a significant transformation, and at the forefront of this change is the Next Generation NCLEX. But how is it different from the traditional NCLEX-RN for anyone trying to become an RN? And how does it test a candidate’s knowledge with the real-life nursing scenarios?

Well, that’s what we aim to cover through this blog. I’ll tell you what this exam is, what the topics covered, and how FBNPC’s NCLEX program will help with the next gen exam. Let’s begin.

What is Next Generation NCLEX?

Launched in April 2023, the Next Generation NCLEX® (NGNCLEX) is a new nursing licensure exam launched by the NCSBN (National Council of State Boards of Nursing). An advanced version of the traditional NCLEX. It’s designed to assess a candidate’s readiness to practice safely and effectively in a variety of healthcare settings.

The traditional NCLEX-RN exam primarily focused on content recall and test-taking skills. But the NGNCLEX emphasizes critical thinking, clinical judgment, and the ability to apply knowledge to real-world scenarios.

The Next Gen NCLEX exam is designed to better reflect the complexities of modern nursing practice. It ensures that new graduates are equipped with the skills needed to provide high-quality care in a rapidly evolving healthcare environment.

Speaking of the differences between NCLEX and its advanced version, let’s cover it in detail.

How is Next Generation NCLEX Different From the Regular NCLEX?

NCSBN launched the Next Generation NCLEX exam (NGN) in 2023 as an advanced version of the traditional NCLEX, highly regarded as a world’s premier licensure exam. But from what we have gathered, there are some significant differences between the two.

The introduction of NGN brought forth some significant changes to the traditional NCLEX format, with a strong focus on testing clinical judgment of the nursing candidates. NCSBN designed the NGN to better assess a nurse’s ability to make safe and effective clinical decisions even in most complex situations.

Let’s see how NGN differs from the traditional NCLEX-RN in terms of a variety of factors, of which we’ll discuss a few below.

Clinical Judgment Measurement Model (CJMM) Focus

NGN is built on NCSBN’s Clinical Judgment Measurement Model (CJMM). It emphasizes six layers of clinical judgment:

• Recognizing cues
• Analyzing cues
• Prioritizing hypotheses
• Generating solutions
• Taking actions
• Evaluating outcomes

Traditional NCLEX, in comparison, tested knowledge and basic application skills, but didn’t focus on step-by-step decision-making necessary for accurate clinical judgment.

New Question Types

As opposed to the traditional NCLEX-RN, the Next General NCLEX involves more innovative question formats. They aim to capture more aspects of clinical reasoning. These include:

• Extended Multiple Response: MCQs with more than one correct answer (meaning multiple choices), encouraging analysis of each option for careful decision-making.
• Matrix/Grid: This component allows test-takers to assess multiple variables across a grid format, simulating complex clinical scenarios.
• Cloze/Drop-Down Menus: Fill-in-the-blank or drop-down choices that prompt specific decisions in a sequence. For something like completing a care plan.
• Highlighting/Enhanced Hotspot: Allows candidates to identify key information or highlight relevant sections within a clinical scenario.
• Bowtie and Trend Questions: These involve organizing information or recognizing trends in patient data to assess treatment prioritization.

Compare NCN to the NCLEX on this factor and the latter lacked the enhanced scenario-based depth.

More Emphasis on Realistic Clinical Scenarios

The NGN questions are embedded in rich clinical case studies. That means, the candidate will need to navigate a series of interrelated questions about plausible patient scenarios. It’s a better showcase of the layered decision-making process nurses face in real-life situations.

Traditional NCLEX-RN questions, on the other hand, were often based on clinical content. But they used to assess if the nurse is knowledgeable about the isolated facts or direct applications. However, the interconnected, case-based structure now used in NGN is missing in its predecessor.

Enhanced Assessment of Decision-making Skills

One of the best highlights of NGN is how it effectively assesses the nurse’s decision-making skills. Here’s what it emphasizes by integrating multiple steps of the CJMM:

• Cue Recognition and Analysis: Requires nurses to identify and analyze relevant patient information.
• Prioritizing and Hypothesis Generation: Emphasizes the need to prioritize potential patient issues and develop hypotheses for treatment.
• Solution Generation and Action Taking: Tests the nurse’s ability to identify appropriate interventions.
• Evaluation of Outcomes: Assesses if the nurse can evaluate if their actions effectively addressed the patient’s needs.

The traditional NCLEX-RN assessed judgment skills more indirectly, typically through standard question formats. But that may not have fully captured the complexity of the clinical judgment process.

Higher-level Cognitive Skills

The NGN places a stronger emphasis on critical thinking and clinical reasoning or simple memorization or simple knowledge recall. It requires nurses to apply their knowledge in nuanced ways, simulating the pressure and variability of actual clinical settings.

That is a shift from the traditional NCLEX-RN, which included critical thinking elements. But it’s less explicitly structured to assess clinical reasoning at this advanced level.

Conceptual Changes

Unlike the traditional NCLEX, which primarily tested content recall, the NGNCLEX emphasizes critical thinking, clinical judgment, and the ability to apply knowledge to real-world scenarios. Here’s what that entails:

• Observe and assess presenting situations: The NGNCLEX requires candidates to analyze complex clinical scenarios and identify relevant patient information.
• Identify the patient’s concern: Candidates must determine the underlying issue or problem that the patient is facing.
• Generate the best possible evidence-based solutions for safe client care: Based on their assessment, candidates must develop appropriate and safe interventions using evidence-based practices.

By incorporating the CJMM, the NGN fundamentally redefines how nursing competencies are evaluated. That means a shift from knowledge-based testing to a deeper, judgment-centered approach. So the nurses are better equipped to make sound clinical decisions, thereby improving patient outcomes and safety in today’s complex healthcare environments.

Next Generation NCLEX-RN (NGN) Scoring System

NGN uses a polytomous scoring system to assess more complex answers with multiple possible components. That provides a more nuanced evaluation of the nurse’s clinical judgment. Let’s cover this scoring system in detail.

What is Polytomous Scoring?

In traditional NCLEX-RN scoring, most items were scored dichotomously: an answer was either correct (1 point) or incorrect (0 points), without partial credit. Polytomous scoring, however, allows for partial credit based on the accuracy of each component within a complex item, resulting in more flexible scoring across a range of possible answers.

What is Polytomous Scoring?

In traditional NCLEX-RN, most items were scored dichotomously. That means, the answer is either correct (1 point) or incorrect (0 points); there is no partial credit. NGN scoring is polytomous, which allows for partial credit based on the accuracy of each component within a complex item. That results in a more flexible scoring across a range of possible answers.

How Does Polytomous Scoring Work in the NGN?

Well, there are three points to consider:

• Complex Question Types: NGN items include matrix/grid questions, extended multiple response, and trend items. That requires test-takers to make multiple decisions within a single question or answer across multiple components.
• Partial Credit: Polytomous scoring awards points for each part of a response that is correct. This way, candidates can earn partial credit if they demonstrate some understanding of the scenario, even if they do not answer every part correctly.
• More Accurate Assessment of Clinical Judgment: This system reflects a more realistic evaluation of clinical judgment. For example, in a matrix-style question, a candidate might identify some cues correctly but miss others. Rather than marking the entire answer as wrong, the polytomous system awards points for the correct aspects.

All in all, NGN gives a more accurate reflection of the candidate’s abilities.

Benefits of Polytomous Scoring

Here are a few benefits of NGN’s polytomous scoring over NCLEX’s dichotomous scoring:

• Fairer Evaluation: Recognizes partial knowledge and avoids penalizing candidates for complex tasks where full accuracy on each component may not be achieved.
• Detailed Insight into Clinical Skills: Allows the NCLEX to better assess a nurse’s clinical reasoning process, highlighting areas of strength and potential improvement.
• Alignment with Real-World Nursing: Since nursing often involves making best-possible decisions in multifaceted situations, polytomous scoring aligns well with the nature of clinical practice.

As for the candidates, they can feel more validated on their abilities rather than just correct or incorrect.

Example of Polytomous Scoring

Suppose a question asks the candidate to identify key signs and symptoms of sepsis in a patient case. The matrix might have five possible symptoms, and the candidate correctly identifies three. Instead of receiving zero points (as would happen in a dichotomous system), NGN awards the candidate partial credit for the correct answers.

What are the New Item Types in NGN?

The NGNCLEX may introduce new item types or variations of existing item types to better assess candidates’ skills and knowledge. These might include more complex scenarios, interactive elements, or simulations.

• Extended drag-and-drop items: These items require candidates to drag and drop information or images into the correct categories or locations.
• Cloze drop-down items: These items have blank spaces that candidates must fill in by selecting the correct word or phrase from a drop-down menu.
• Matrix grid items: These items present information in a table format and require candidates to select the appropriate response for each row or column.
• Enhanced hotspot: These items require candidates to click on specific areas of an image or diagram to identify correct answers.
• Extended multiple choice: These items may have more than one correct answer or may require candidates to select the best answer from several options.

These new item types are designed to assess a nurse’s ability to think critically, analyze information, and make sound clinical judgments.

Bow-Tie and Trend

The NGNCLEX introduces new item types, such as the standalone item, which includes a bow-tie diagram to illustrate the relationship between interventions and outcomes. The trend item assesses a candidate’s ability to analyze findings from the client conversations and machine-aided data and provide the appropriate care. Then, evaluate the client’s response to the treatment.

What these changes and additions to the examination for becoming a registered nurse show is the evolution of nursing as a field. So it’s important to ensure that new graduates are prepared to meet the challenges of modern healthcare.

For that, it would be beneficial to opt for our NCLEX prep course. We cover both the traditional as well as Next Generation NCLEX, so the candidate is well-prepared for the journey to come.

How to Register for the Next Generation NCLEX?

The exam is designed to assess a candidate’s readiness to practice safely and effectively in a variety of healthcare settings. The process involves rigorous academic preparation, clinical experiences, and passing the NGNCLEX exam.

Step 1: Eligibility Verification

The first step of the process is to ensure you meet the eligibility requirements set by the NCSBN and your state’s board of nursing. This typically involves graduating from an accredited nursing program and completing any necessary clinical hours.

Before you can apply for the NCLEX, you must confirm that you have met all of the eligibility requirements for your state. These requirements may vary depending on your laws and regulations set by your state’s nursing body, but typically include:

• Graduation from an accredited nursing program
• Completion of a certain number of clinical hours
• Passing a background check
• Payment of any required fees

You can find more information about the eligibility requirements for your state on your state’s board of nursing website. With these requirements, the aim is to get a valid measurement of clinical judgment in nursing.

Step 2: Register with Pearson VUE

Once you’ve been approved for licensure or registration based on your eligibility requirements, it means your clinical judgment and decision making is acceptable. Then the next step is to register with Pearson VUE. This agency is the official testing provider for the NCLEX. You’ll create an account and provide personal information, such as your name, contact information, and program code.

The registration fee for the NCLEX varies by state. You’ll need to pay this fee online or by phone during the registration process.

Step 3: Obtain an Authorization to Test (ATT)

After completing the registration process, the NRB will send you an Authorization to Test (ATT). This document confirms your eligibility to take the NCLEX and includes important information about your exam date and location.

The ATT typically includes the following information:

• Your name and contact information
• Your state’s board of nursing registration number
• Your exam date and location
• Your exam start time

You’ll need to bring your ATT with you to the testing center on the day of your exam.   

Step 4: Schedule Your Exam

Once you have your ATT, you can schedule your exam through the Pearson VUE website or by phone. You’ll need to select a testing date and location that is convenient for you. The NCLEX is offered at various times and locations throughout the year. You can choose a date and location that is convenient for you and allows you to focus on your studies.

When scheduling your exam, you’ll need to provide your ATT number and personal information. You’ll also need to pay a deposit for the exam.

Step 5: Prepare for the Exam

Now that your NGNCLEX exam is scheduled, it’s time to start prepping. There are many resources available to help you prepare, such as practice tests, study guides, and online courses.

To that end, it would be best to get our FBNPC’s NCLEX course offers live face-to-face guided sessions, computer-generated mock tests, practice questions, and much more. We will help you prepare for the exam in the best way possible.

FAQs on Next Generation NCLEX

Let’s Summarize

The Next Generation NCLEX (NGNCLEX) represents a significant advancement in nursing education and licensure. It ensures that new graduates are equipped to meet the challenges of modern healthcare.

To successfully navigate the NGNCLEX, aspiring nurses must:

• Understand the conceptual changes and new item types introduced in the exam.
• Familiarize themselves with the computerized adaptive testing (CAT) format.
• Prepare thoroughly by utilizing a variety of study resources.
• Register for the exam in a timely manner and comply with all eligibility requirements.

If you need help with securing the best results with the NGNCLEX and becoming the best registered nurse in Canada, Australia or the USA, connect with our experts today!