Provide opportunities for students to use clinical judgment 2. Since 2012, the National Council of State Boards of Nursing (NCSBN), the organization that develops the NCLEX® Licensure Examination, has been working on a revision of the NCLEX for both RNs and PNs. This approach emphasizes the nurse’s effective use of clinical judgment. In the revised NCLEX exam, known as the Next Generation NCLEX (NGN) , the questions will focus on a client situation, include some unfolding case studies, and require the test-taker to use clinical judgment to correctly answer the questions. The NCSBN has developed a Clinical Judgment Measurement Model (CJMM), to illustrate the use of clinical judgment in nursing practice. This model guides how the Next Generation NCLEX (NGN) will measure the clinical judgment of the test taker. The NCSBN NGN website has resources available for educators as they transition to this new model. Terms such as critical thinking, problem solving, and clinical judgment are familiar terms in nursing, but the NCSBN has clarified the difference among these terms, as is shown in the figure below.
CRITICAL THINKING Using logic and reasoning interventions to resolve complex problems. (Unseen)
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PROBLEM SOLVING Developing and evaluating interventions to resolve complex problems. (Unseen)
CLINICAL JUDGMENT Recognizing cues about a clinical situation, generating and weighing hypotheses, taking action and evaluating outcomes for the purpose of arriving at a satisfactory clinical outcome. Clinical judgment is the observed outcome of problem solving and critical thinking.
A key component of the Clinical Judgment Measurement Model is the identification of cognitive skills required to make an effective clinical judgment. The NGN test questions will require students to use these skills to answer the questions correctly, thus replicating decisions that nurses will make in actual practice. Preparing students for the NGN—and clinical practice—will require faculty to consistently provide opportunities for students to use clinical judgment skills in class, lab, and clinical experiences. Table 1 outlines the cognitive skills necessary for effective clinical judgment as well as relevant questions instructors should ask to help students learn these skills (NCSBN, 2019).
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