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What Is The Next Generation NCLEX Exam & Why It Is Important?

The next generation NCLEX exam, Clinical Judgement Model, and Next Generation NCLEX review courses are now setting the standard of nursing program curriculums across the U.S. To understand this change and prepare students and schools to meet these new challenges, we have gathered the most up to date news on the new NCLEX.

What Is the Next Generation NCLEX-RN Exam?

The Next Generation NCLEX exam (also called the NGN) builds upon the traditional NCLEX exam, posing complex hypothetical questions that require nursing students to demonstrate their clinical judgment skills in real-world scenarios. This new test will be released by 2023 at the earliest.

The National Council of the State Boards of Nursing (NCSBN) has decided to analyze the NCLEX exam to determine what changes in the test are necessary to ensure that nurses are ready to face all the challenges they will meet in real-world situations.1 This has been called the Next Generation NCLEX Project, and soon it will change the way that students need to prepare for their nursing certification.

How the Next Generation NCLEX Exam Works

The NCSBN has created a model that represents the several phases of technical skill and knowledge that nurses must demonstrate competence in to pass the NCELX. A special research section was added to the end of NCLEX exams that was intended to collect data on new item types that could expand or enhance the measurement of entry-level nursing competence that includes clinical judgment. As a result, the Clinical Judgement Model was created to enhance the NCLEX exam and ensure that all nursing students, working toward an ADN or BSN, are prepared for the decisions they must make in real-world medical scenarios.

The Clinical Judgement Model

The model is a 5-layer decision-making model that is meant to further assist all nursing students in their cognitive abilities and decision-making skills in real-world scenarios. The next generation NCLEX exam will use this model to teach students these skills. All accredited and trusted medical schools should offer extensive training in this logic model in preparation for the NGN.

The increased focus on step by step decision-making skills will increase the difficulty of the NCLEX exam but ultimately better prepare students for their careers in the medical field. The new NCLEX means better evaluation of a candidate’s readiness to enter the medical field.

Preparing for the Next Generation NCLEX Exam

The NGN exam will test students to gauge their clinical judgment and decision-making aptitude. Medical schools with RN nursing programs that are already properly preparing their students for the NCLEX should have no problem adjusting their curriculum for the NGN exam. However, some new items will be like nothing seen in previous NCLEX exams.

For example, next generation NCLEX exam reviews will take on the challenge of differentiating between acute problems and those needing immediate attention using environmental cues: the patient’s location, medical needs, and time pressure cues.

There are a number of cues that students will have to learn and master during their NGN exam reviews which you can find in the latest NGN spring 2019 News Letter (PDF). The next generation NCLEX exam, NGN, will ultimately improve a nurse’s readiness before entering this incredible field in the real world, with real people.


  1. Alyson Brenton, NCSBN ­– Next Generation NCLEX® (NGN) Project