The National Council of State Boards of Nursing (NCSBN) has implemented changes to the NCLEX examination to ensure that it continues to accurately measure the competencies and clinical judgment skills necessary for safe and effective nursing practice. The NCSBN recognized the need to adapt the exam to keep pace with the evolving healthcare landscape, technological advancements, and changes in nursing education. The changes to the NCLEX exam are designed to better assess a candidate's ability to make clinical judgments, which are essential for providing high-quality patient care.

The NCSBN Clinical Judgment Measurement Model (NCJMM)

The NCSBN Clinical Judgment Measurement Model (NCJMM) is the foundation of the changes to the NCLEX. It serves as a framework for designing and implementing the Next Generation NCLEX (Next Gen NCLEX). The NCJMM emphasizes the importance of clinical judgment in nursing practice and identifies the core components of clinical judgment, including recognizing cues, analyzing data, making inferences, prioritizing actions, and reflecting on outcomes. The Next Gen NCLEX aims to assess these components more effectively, providing a more comprehensive evaluation of a candidate's ability to make sound clinical judgments.

When is the NCLEX changing?

The implementation of the Next Gen NCLEX is planned for a phased approach. The first phase is expected to begin in 2023, with a pilot testing period to evaluate the effectiveness of the new items and scoring models. The pilot phase will allow the NCSBN to gather valuable data and feedback from test-takers, which will inform further refinements to ensure the reliability and validity of the exam. The subsequent phases of implementation will be determined based on the outcomes of the pilot phase.

What is changing about the NCLEX?

The Next Gen NCLEX introduces several significant changes to the current exam format. These changes are designed to better assess a candidate's clinical judgment skills and their ability to make safe and effective nursing decisions. Let's explore the key components of the Next Gen NCLEX:

Key components of the Next Gen NCLEX

Next Gen NCLEX items: The exam will include a new type of item called "Next Gen items." These items are interactive and require candidates to demonstrate their clinical judgment abilities by actively engaging with the content presented. These items may include tasks such as drag and drop, multiple response, hotspots, and enhanced multiple-choice questions.

  1. Minimum/maximum length of the exam: The Next Gen NCLEX will have a variable-length format. The minimum number of items will remain the same as the current NCLEX, but the maximum number of items may vary based on the candidate's performance and the exam's ability to measure their clinical judgment accurately.
  2. Next Gen NCLEX scoring models: The scoring models for the Next Gen NCLEX will differ from the current exam. The NCSBN is exploring three scoring models, which are designed to provide a more precise evaluation of a candidate's clinical judgment skills:
  • 0/1 Scoring Rule: This model focuses on whether a candidate's response to an item is correct or incorrect, assigning a score of either 0 or 1 for each item.
  • +/- Scoring Rule: This model takes into account the level of confidence in a candidate's response. It assigns scores of +1, 0, or -1 based on the level of correctness and confidence.
  • Rationales Scoring Rule: This model evaluates the quality of a candidate's clinical reasoning and the rationale provided for their chosen response. It assigns scores based on the depth and appropriateness of the rationale.

What is not changing about the NCLEX?

While the Next Gen NCLEX brings significant changes to the exam, certain aspects will remain consistent with the current format. These include:

Time allowed

The time allowed for the Next Gen NCLEX will remain the same as the current exam. Candidates will have a specified period to complete the exam, and the adaptive algorithm will dynamically adjust the difficulty level and content of the questions within that time frame.

Delivery method

The delivery method of the NCLEX will also remain unchanged. The exam will continue to be administered through computer-based testing (CBT) at authorized testing centers. This format allows for efficient and secure delivery of the exam while providing candidates with a familiar testing environment.

Candidate performance report (CPR)

The Candidate Performance Report (CPR) will continue to be available to candidates after completing the Next Gen NCLEX. The CPR provides valuable feedback on individual performance, including the candidate's strengths and areas for improvement. It serves as a useful tool for self-assessment and identifying areas to focus on for future professional development.

Evaluating Next Gen NCLEX Items

The Next Gen NCLEX items will require candidates to think critically and apply their clinical judgment skills effectively. To succeed in answering these items, candidates should consider the following strategies:

  • Practice active engagement: Next Gen items often require candidates to interact with the content in a more dynamic way. Engaging with the item actively, such as dragging and dropping, selecting multiple responses, or identifying hotspots, can help candidates better comprehend and respond accurately.
  • Analyze the cues and context: Next Gen items may provide contextual information, patient data, or visual cues that are essential for making sound clinical judgments. Carefully analyzing these cues and considering their implications will aid in selecting the most appropriate response.
  • Apply clinical reasoning: The Next Gen NCLEX emphasizes the importance of clinical reasoning. Candidates should not only focus on recalling factual information but also utilize their critical thinking skills to evaluate the situation, identify potential risks, and determine the most suitable actions.

Getting started with the Next Gen NCLEX

As a nursing candidate preparing for the Next Gen NCLEX, there are several steps you can take to ensure you are ready for the changes:

  1. Stay informed: Keep yourself updated on the latest information and announcements from the NCSBN regarding the Next Gen NCLEX. Regularly visit their official website, read news updates, and follow their social media channels to stay informed about any developments or important dates.
  2. Utilize available resources: Take advantage of the study resources provided by the NCSBN and other reputable sources. Familiarize yourself with the new item types, review sample Next Gen items, and practice answering questions that focus on clinical judgment and critical thinking.
  3. Seek support from educators and peers: Engage with your nursing educators and fellow students to discuss the changes and share study strategies. Collaborative learning and group discussions can help deepen your understanding of the Next Gen NCLEX and provide additional perspectives on how to approach the exam effectively.
  4. Adapt your study methods: Recognize the shift in focus from knowledge recall to clinical judgment assessment. Adjust your study methods accordingly by incorporating case studies, simulations, and critical thinking exercises into your study routine. This will help you develop and refine your clinical judgment skills.


In conclusion, the changes to the NCLEX examination, known as the Next Gen NCLEX, are driven by the need to adapt to the evolving healthcare landscape and ensure that nursing candidates possess the necessary clinical judgment skills for safe and effective practice. The NCSBN Clinical Judgment Measurement Model (NCJMM) forms the foundation of these changes, emphasizing the importance of clinical judgment in nursing. The Next Gen NCLEX introduces key components such as new item types, an enhanced focus on clinical judgment, and integrated test plans to assess candidates more comprehensively.

While the Next Gen NCLEX brings significant changes, certain aspects remain unchanged, including the time allowed for the exam, the delivery method through computer-based testing, and the availability of the Candidate Performance Report (CPR) for individual feedback. Candidates can prepare for the Next Gen NCLEX by familiarizing themselves with the NCJMM, practicing with sample items, and developing critical thinking and clinical reasoning skills.

As the Next Gen NCLEX is implemented in a phased approach, candidates should stay informed through official channels and utilize study resources specifically designed for the updated exam. Engaging in self-assessment and focusing on areas of improvement will contribute to effective preparation.

Overall, the Next Gen NCLEX aims to provide a more comprehensive and accurate assessment of a candidate's clinical judgment skills. By embracing these changes, nursing candidates can enter the profession with the necessary competencies to provide safe and high-quality patient care. The Next Gen NCLEX represents an important step forward in ensuring the continued excellence of nursing education and practice.


Frequently Asked Questions About New Next Gen NCLEX

When will the Next Gen NCLEX be fully implemented?

The National Council of State Boards of Nursing (NCSBN) has not yet announced an official date for the full implementation of the Next Gen NCLEX. However, they are committed to providing ample notice to educators and candidates to ensure a smooth transition.

What are the key components of the Next Gen NCLEX?

The key components of the Next Gen NCLEX include new interactive item types called "Next Gen items," a variable-length format, and three different scoring models: 0/1 Scoring Rule, +/- Scoring Rule, and Rationales Scoring Rule. These components are designed to assess candidates' clinical judgment skills and enhance the accuracy of the exam.

Will the time allowed for the Next Gen NCLEX be the same as the current exam?

The exact time allowed for the Next Gen NCLEX has not been announced yet. The National Council of State Boards of Nursing (NCSBN) is conducting research and piloting activities to determine an appropriate time limit for the new exam.

How will the Next Gen NCLEX be delivered to candidates?

The Next Gen NCLEX will still be administered as a computerized adaptive exam (CAT) delivered on a computer at authorized testing centers, similar to the current format.

Will candidates receive a performance report after taking the Next Gen NCLEX?

Yes, candidates will continue to receive a Candidate Performance Report (CPR) after taking the Next Gen NCLEX. The CPR provides feedback on the candidate's performance, allowing them to identify areas of strength and areas that may require further improvement.