Nurse Educators – the Next Generation NCLEX is quickly approaching and will go live April 1st, 2023. This means that ALL NCLEX candidates who take the test on or after 4/1/2023 will be taking the NGN exam. I am working with many graduates who are currently struggling with passing the NCLEX – and we are full speed ahead to get them passed before the NGN. To best prepare, I have been studying the Next Generation NCLEX test plans, as well as the new question types and I am certain that Nurse Educators will all face new challenges with preparing our candidates for NCLEX success. But – don’t fret! I am paying close attention to how the NGN will challenge test-takers and I want to share with you 3 key points that will help you and your team develop high-quality NGN Style lesson plans & practice questions.
#1: NGN SUCCESS STARTS WITH TEACHING & VALIDATING CONCEPTS – NOT CONTENT
One of the best ways that we Nurse Educators can ensure that we are preparing our students to the best of our ability is to understand the concepts in which the NCLEX challenges. The reason why I am including this information here is because there are consistent inconsistencies in the way that Nursing Education is delivered. Some programs still teach via the Medical Model. Other programs teach using a Nursing Concepts-Based Model. These varying education delivery methods cause issues for NCLEX success. The NCLEX doesn’t expect candidates to know EVERYTHING in order to pass the exam. It’s not about what the candidate knows. The NGN cares about what the candidate will do in certain situations. Therefore, our lesson plans and test questions should challenge conceptual thinking – not memorization of facts.
One of the most common issues that I observe with my clients is a lack of understanding of how to appropriately utilize The Nursing Process. Another common problem is that my clients are not clear on role responsibilities or the limitations of the Nurse. I have recognized this as a major barrier to the success of my clients. As a result, I have spent years creating an NCLEX Strategies for Success Program that aims to fill these gaps – and so far, I’ve found great success.
Important concepts to teach & validate competence:
- Roles & Responsibilities of the Nurse (RN & LPN/LVN)
- Advantages & Limitations of Scope of Practice (RN & LPN/LVN)
- The Nursing Process (AADPIE)
- Prioritization & Delegation
- Therapeutic Communication & Environment
- Medication Management
- Documentation & Legal Considerations
- Advocacy & Ethics
- Conflict Resolution & Risk Reduction
- Teaching & Learning Principles
These concepts are important to the success of an entry-level Nurse. As a result, the NGN is using a new conceptual framework for measuring candidate competence. Therefore, the NGN has created a new layered approach at measuring critical thinking and clinical reasoning for test-takers. This offers a much more precise assessment of the candidate’s ability to apply and analyze data. The more accurate a candidate is with answering NGN test items, the “safer” they are in making decisions. NGN questions are designed to challenge many levels of comprehension, but the ability to apply and analyze data remain passing standards for the exam.
The NGN conceptual framework below is most useful to Nurse Educators in the development of test questions and measuring varying levels of student competence. Tanners’ conceptual framework is best used by Nurse Educators for teaching concepts of Nursing practice. See the two conceptual frameworks below for comparison:
Tanner’s Framework for Clinical Judgement
“We must always make it a priority that our students can ask the right questions so they can apply and respond appropriately, and we must move our students beyond the tasks and into understanding the bigger picture.” – Keith Risher, PhD, RN, CCRN, CEN – heard during the 2022 NCLEX Conference.
#2: NGN SUCCESS INCLUDES EMPOWERING STUDENTS TO EMBODY THE ROLE OF THE NURSE
Over 99% of my clients come to me with feelings of inadequacy, self-doubt and confusion surrounding the role of the Nurse. As a result, I designed my program to offer opportunities for clients to apply what they already know and challenge them to step into the role of the professional nurse. When interviewing my clients as to the reasons why they felt underprepared, here are some the most common themes:
- Limited opportunities to apply what they’ve learned in lecture & skills/simulation into practice
- Not offered chances to make clinical decisions on their own
- Few to no opportunities to practice delegation skills in real-time
- Never taught test-taking strategies or systematic approaches to critical thinking
- Professors & Clinical Instructors use intimidation tactics which causes students to be afraid to ask questions
- Educators/Schools of Nursing do not teach the concepts of Managment of Care or Coordination of Care & focus too much on Nurse-Related tasks & skills
It is my belief that empowering students to embody the role of the Nurse from fundamentals is integral. Students who can make the perspective shift from “learning new content” to “performing the duties of the Nurse” will pass! Utilizing salient case-based scenarios in class is just one of many examples that Nurse Educators can implement to engage students to step into the role of the Nurse and become more confident in their abilities. We must nurture our students to perform the duties of the Nurse early in our programs. That way, we can progressively challenge them to incorporate more skills, critical thinking, and demonstrate safe & effective Nursing practice.
“We must filter the knowledge of the textbooks to what’s really relevant to Nursing practice.” – Keith Risher, PhD, RN, CCRN, CEN – heard during the 2022 NCLEX Conference
#3 NGN SUCCESS STARTS WITH APPLICATION & ANALYSIS LEVEL LEARNING IN FUNDAMENTALS
I have been a RN for over 12 years, and for 9 of those years, I have been teaching Nursing. In many cases, I have disagreed with colleagues in the way that we are challenging our fundamental students to learn. Many of the lessons and assessments we use focus heavily on recognition recall and comprehension level thinking. To the defense of many of my colleagues, this is because we are introducing information at such a rapid speed, students have a difficult time applying what they don’t fully understand. In my defense, I have always felt that we teach TOO MUCH content and not enough concepts. For programs that are not carefully designed to emphasize conceptual learning, this can be difficult for Nurse Educators. However, focusing on Nursing concepts that consider the bigger picture are more relevant to current practice.
While having a basic level of knowledge is imperative, no one – including the NGN – expects Nurses to be walking textbooks. Therefore, we must begin to challenge our student’s ability to notice, interpret and respond to assessment finding starting in fundamentals. We must challenge them to make decisions on their own without penalty for incorrect decisions – providing a safe space to explore options and learn without grades.
Therefore, I strongly believe that if we start by teaching the “why”, it is much easier for students to understand. If we teach why an accurate lung assessment is important, students will have less difficulty learning the skill, identifying lung sounds and choosing appropriate interventions. Fundamentals is often a culture shock for Nursing students, but it doesn’t have to be. Nurse Educators should teach students how to apply & analyze what they are learning early in the program. Therefore, students will be started with a strong foundation & an increased learning potential for program & NGN success!
I AM HERE TO HELP YOU DEVELOP STRATEGIES FOR NGN SUCCESS!
“Keep it at their level, don’t go too deep in the weeds, but noticing is a fundamental skill of clinical reasoning that needs to be integrated at the beginning of our programs to make that connection and how we can leverage clinical reasoning. It’s all about applying knowledge.” – Keith Risher, PhD, RN, CCRN, CEN – heard during the 2022 NCLEX Conference
I really enjoyed learning more about the Next Generation NCLEX and how it will lead the future of Nursing Education into adequately preparing our students for success with entry into practice! The NCLEX is leveling-up the difficulty level substantially! They are really emphasizing critical thinking, nursing & clinical judgement, and a candidate’s ability to apply and analyze information to make decisions. There will be LESS emphasis on memorization of facts – and I am 100% behind this change. Additionally, the NGN will be using NEW question formats that will prove to pose a significant learning curve for educators and NCLEX candidates. These new question formats are designed to capture layered assessments of a candidate’s competence in knowledge & critical thinking capacity. Finally, writing test items that are reflective of the new NGN question formats & new framework for measuring candidate competence will require careful understanding of the conceptual frameworks that the NGN will be challenging.
If you found this article helpful and want to learn more about how I can help you or your team develop strategies for NGN Success – I’d love to have a chat with you! Visit thenursespeak.com/contact and get in touch with me! Integrating NGN Strategies for Success can be challenging, but it certainly isn’t impossible if we Nurse Educators stick together! Remember – Excellent Nursing Practice is ALWAYS a Team Effort!
I look forward to working with you soon!
Best,
Damion Jenkins, MSN, RN | NCLEX & NGN Prep Expert
I luv it… good old Nursing Process. Critical thinking and the nurses role…Yesss.
1. How do they begin to recognize and/or handle change., I.e., subtle patient activity/inactivity; prioritize for new admissions.
2. As I speak to some current nurses, it is difficult for them to share “who they are” and “what they do” with their patients.
I’ll just stop here…ty
Thank you, Sharon for your thoughtful response!
1) It is important for us Educators to focus on establishing expectations and providing LOTS of opportunity to practice moving through the process of recognizing and then addressing changes in status (subtle or emergent). This starts with teaching the RULES, PRINCIPLES and GUIDELINES that govern decision-making and critical thinking. AKA – The Rules of Prioritization. Clinical Reasoning. Utilizing The Nursing Process. Understanding the “why” behind the decisions we make.
2) This does not surprise me. In the short 12 years that I’ve been a Nurse – I find that MOST people have a difficult time sharing or explaining what they do because too much focus is put on tasks and not the role/responsibilities or POWER of the Nurse. “I assess patients, I give them their medications, I do wound care, I help them complete their ADLs, I help them use the bathroom, etc.” Few New Grads know what they do. I believe this starts in Nursing School. We educators need to do a MUCH BETTER JOB of empowering our future Nurses with the awesome power that they have once they fully step into the role of the Nurse. This isn’t always easily articulated, but I feel that much of our traditional way of teaching Nursing should be reversed. Teach the bigger, more complex theories, roles, responsibilities, Nursing History, Social, Economic, Political and Societal challenges that Nurses are working towards managing, and then once the students better understand their potential, the skills, meds, critical thinking and applying what they are learning will come much easier. We need to give the answers up front, and then challenge them to use that information in more consistent ways. Less theory exams and MORE practical exams, skills demonstrations, simulation, role-play, clinical, etc. We don’t need Nurses who are walking textbooks. We need Nurses who can take care of themselves, their patients and the profession. We NEED Nurses to be EMPOWERED!