Wolters Kluwer is here to help you prepare students for the changes to come on the NCLEX® and the challenges of practice.

Taking the NCLEX is a significant step in a nurse's journey, and every day after is equally important when you are entrusted with the care of others.

Because of the pressure you face to produce highly prepared nurses for practice, Wolters Kluwer has always had a robust case-based, high-fidelity approach to nursing education. We have been by your side, publishing strong curriculum tools and robust instructor resources, to help make it easier and less time-consuming for you to teach your students to think like nurses.

What is the clinical judgment gap?
You may have heard about the Next Generation NCLEX® project. The NCSBN wants to change how they evaluate clinical judgment following a study that concluded:

50%
Fifty percent of entry-level nurses were involved in practice errors.

65%
Sixty-five percent of entry-level nurse errors were related to poor clinical decision-making.

20%
Twenty percent of employers were satisfied with decision-making abilities of entry-level nurses.

Top 5
Clinical judgment is one of the top five required skills needed upon entry into the field.

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Closing the clinical judgment gap

More than ever, today’s practicing nurses are required to accurately assess, use evidence, and make sound clinical judgments in order to ensure the most effective patient outcomes. To meet that need, the Next Generation NCLEX will use case studies that focus on the kinds of decisions nurses have to make.

At Wolters Kluwer, we know that helping nursing students acquire knowledge is not enough. That’s why we, in collaboration with educators around the country and partners like the NLN and Laerdal®, have created resources that give students ample opportunities to apply their knowledge, think critically, and use evidence to make good clinical decisions — to practice thinking like nurses:

  • vSim® for Nursing scenarios require students to identify and interpret information and identify appropriate nursing actions.
    • Since the beginning, vSim has been an environment to practice clinical judgment. The Advisor and Procedures content helps students decide which interventions can help deliver expected outcomes — students can start to lean on these to prioritize and generate solutions.
  • Case vignettes in our Lippincott® CoursePoint Interactive Modules help students recognize cues to identify the most clinically important information.
    • The Practice & Learn cases in CoursePoint weave in clinical judgment skills by asking students to recognize and analyze cues first, then to generate solutions by considering interventions and how/why they would achieve desired outcomes. Students then have to consider how the intervention should be accomplished = take action. This creates a great foundation for these skills.
    • The multipart video cases in CoursePoint give students an opportunity to practice with unfolding, multi-part cases. Because they are so engaging, they present a wonderful opportunity for students to practice with cases in a low-stakes, fun way.
  • Lippincott® DocuCare enhances clinical reasoning by contextualizing realistic patient care scenarios with hands-on documentation.
    • New clinical judgment activities in DocuCare reference the NCSBN domains and are built around existing cases.
  • Lippincott® PassPoint brings fidelity to the NCLEX prep experience through evidence-based information that helps students make sound clinical decisions.
What is clinical judgment? Clinical judgment is the observed outcome of critical thinking and decision-making.
The latest information from leading experts
Stay informed about the next generation of nursing education with some of the most trusted names in the field.
Screenshot of Stay on the front line of clinical judgement and next generation NCLEX video
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(April 2021) More than ever, today’s practicing nurses are required to accurately assess, use evidence, and make sound clinical judgments to ensure the most effective outcomes. In this webinar, Jason Schwartz, Director of Outreach for the NCSBN provides current information on the test design changes to the NCLEX as you prepare students for the exam and for their transition to practice.

Integrating clinical judgment skills in nursing curriculum and improving entry-level practices

Dr. Desiree Hensel, Dean and Professor, Curry College School of Nursing talks with Anne Dabrow-Woods, Chief Nurse for Wolters Kluwer about teaching clinical judgment in nursing education programs.

From bedside to brain: The science and art of good teaching

Presenters: Susan Forneris, PhD, RN, CNE, CHSE-A, FAAN, Director, NLN Center for Innovation in Education Excellence, National League for Nursing and Mary Fey, PhD, RN, CHSE-A, Senior Director for Teaching and Learning, Center for Medical Simulation
Teaching higher-level reasoning skills in nursing education is paramount for the success of our future professional nurses. Recent advances in neuroscience research are unveiling intriguing discoveries about how our brain functions — and more importantly, how brain-based learning is changing the face of education today.

Leveraging clinical judgment to foster professional role formation and agency

Presenters: Carol Taylor, PhD, MSN, RN, FAAN; Pamela Lynn, EdD, MSN, RN; and Jennifer L. Bartlett, PhD, RN-BC, CNE, CHSE
This discussion focuses on clinical judgment, with a review of definitions and distinctions, an exploration of several clinical judgment models, and a discussion of the path forward. The importance of clinical judgment in professional role formation is emphasized, and connections are made between competence, confidence, and agency within the context of professional formation.

Uncovering modern insights on critical thinking in today’s learners

Presenters: Susan Forneris, PhD, RN, CNE, CHSE-A, Director, National League for Nursing (NLN) Center for Innovation in Education Excellence and Mary Fey, PhD, RN, CHSE-A, Senior Director of Teaching and Learning, Center for Medical Simulation, Harvard Medical School
Susan Forneris and Mary Fey discuss new insights on how brain science informs teaching and learning and explore how to use new teaching and learning techniques to create experiential learning encounters.

Applying clinical judgment to NCLEX item writing

Presenters: Vicki Moran, PhD, RN, MPH, CNE, CDE, PHNA-BC, TNS, Assistant Professor, St. Louis School of Nursing and Leigh Moore, MSN, RN, CNOR, CNE, Associate Professor of Nursing, Southside Virginia Community College
Nursing faculty are well versed in clinical judgment in their everyday practice in teaching nursing students to make those pertinent nursing care decisions. This webinar provides a theoretical basis for clinical judgment and demonstrates how to apply its use in writing NCLEX-style questions for nursing exams.

Strategies for teaching and assessing students’ nursing clinical judgment skills

Presenters: Diane M. Billings, EdD, RN, FAAN, ANEF, Chancellor’s Professor Emeritus, Indiana University School of Nursing, Indianapolis and Desiree Hensel, BS, MS, PhD, Dean of the School of Nursing, Curry College
In this session, the speakers describe the National Council of State Boards of Nursing Clinical Judgment Model and discuss learning activities targeted at helping students acquire clinical judgment skills. The concept of retrieval-based learning is described while offering examples of how to use tests and other strategies to assess students’ abilities to make clinical judgments.

Teaching with cases: Strategies for learning in and out of the classroom

Presenter: Larry Slater, New York University
Teaching with cases (e.g., case studies, unfolding case studies, reverse case studies) can enhance student learning by providing a more active, engaged, and collaborative learning environment. This on-demand webinar will provide some background on active learning strategies, describe different options for case-based learning, and discuss the integration of cases into classroom (traditional or flipped) and out-of-class activities.

Watch as these thought leaders in nurse education discuss integrating clinical judgment skills into the classroom, into simulation, and into NCLEX prep.

Screenshot from Marilyn Oermann's clinical judgement video
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Marilyn Oermann discusses the importance of cases for promoting clinical judgment.
Screenshot from Larry Slater's clinical judgement video
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Larry Slater discusses how case-based learning in the classroom is a way for faculty to bring their experience as practitioners into the classroom.
Screenshot from Tonya Schneidereith's clinical judgement video
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Tonya Schneidereith discusses how simulation is a great place for students to practice as a nurse.
View Additional Videos on Integrating Clinical Judgement
What’s next?
Wolters Kluwer is actively auditing NCLEX news to filter misinformation and keep you up to date with official developments from the NCSBN.

Here’s what we know:

  • Update: The NCSBN has made these modifications to both the NCLEX-RN® and the NCLEX-PN® parameters as of October 1, 2020, and they will be valid through spring of 2023:
    • The exam has a shortened time limit of five hours.
    • The minimum number of true test items is 60.
    • The maximum number of true test items is 130.
    • 15 pretest items will be reintroduced so minimum length exam is 75 items and max is 145 items with these questions included.
    • The difficulty level and passing standard is unchanged.
    • The current Run Out of Time (root) scoring rule is no longer applicable. The final ability estimate is computed from the response to all completed items. Those scoring above the passing standard will have a passing exam, otherwise the exam will be scored as a fail.
    • For NCLEX-RN®, the voluntary NGN Special Research Section will be reintroduced.
    Lippincott® PassPoint can mimic these test parameters to help students practice for this modified exam.
  • NCSBN has embarked on a multi-year research project to explore new item types with potentially stronger capabilities for accurately evaluating students’ clinical judgment skills before they receive their license to practice.
  • The Next Generation NCLEX will NOT roll out before 2023.
  • All new item types are still in an optional section of the NCLEX for testing.
  • There are two ways the NCSBN plans to measure clinical judgment in the NGN launch: case studies and standalone items.
    • Case studies will be six-part case studies where students must work through multiple layers of the clinical judgment measurement model. There are new item types that appear in these case studies: extended multiple response, extended drag and drop, cloze, enhanced hot spot, and matrix/grid.
    • New standalone items include trends questions and bowtie.
    • See the NCSBN on-demand webinar for more detail.
  • Currently, the NCSBN is conducting research to determine if clinical judgment and decision-making in nursing practice can be reliably assessed. Their research includes focus group studies, usability studies, cognitive labs studies, and the special research section on the current NCLEX. The items they have prototyped are in an optional special research section of the existing NCLEX-RN® for the purpose of collecting functionality data.
  • The NCSBN has investigated scoring methods and will implement partial scoring in the NGN.
  • A decision to move forward would be followed by an extended period of item development, testing, and refinement before new item types appear on the published NCLEX-RN.

Our NCLEX advisory board members are providing guidance and direction related to our NCLEX products, so they are up to date with the most accurate and reliable content.

Keep me on the front line of clinical judgment.
I want to stay informed about the next steps in integrating clinical judgment into my courses, clinicals, and NCLEX prep.