Healthcare is more dynamic than ever, with nurses providing care in the face of unprecedented challenges and constantly developing tech solutions. To ensure public safety and successful careers in nursing, an increased focus on clinical judgment is crucial.
The National Council of State Boards of Nursing (NCSBN) defines clinical judgment as “an iterative process that uses nursing knowledge to observe and assess presenting situations, identify a prioritized client concern and generate the best possible evidence-based solutions in order to deliver safe client care.”
In recent years, the NCSBN identified opportunities to enhance the NCLEX® to more effectively test clinical judgment and prepare new nurses to provide the best patient care. The NCSBN decided to create a new version of the test — The Next Generation NCLEX. Slated for release in April 2023, the new and improved NCLEX will include new question types and an increased focus on clinical judgment.
What Is Clinical Judgment Exams (CJE)?
In anticipation of the upcoming Next Generation NCLEX, NurseThink® and ExamSoft partnered to create Clinical Judgment Exams (CJE). CJE provides pre-written, high-quality assessments to improve nursing education and better prepare students for both the exam and clinical practice.
A critical feature of CJE is the Build-Your-Own Question Bank, which allows nurse educators and exam administrators to build formative and summative assessments using questions written by experts in nursing education and experienced clinicians at NurseThink®. The Build-Your-Own Question Bank gives nurse educators the option to add these prewritten questions to their own assessments or create assessments consisting completely of the questions provided by ExamSoft and NurseThink®.
How Are Nurse Educators Using the Build-Your-Own Question Bank?
Nurse educators use the CJE Build-Your-Own Question Bank for both summative and formative assessments.
After building a formative assessment, instructors administer these quizzes to check in with students on their progress. Often called “muddy points” quizzes, these are ungraded and can be taken in small teams. Instructors may give these quizzes at the beginning of class to assess the knowledge students gained from the reading, which gives the instructor an idea of where they should focus their teaching for the day.
Instructors may also give these quizzes at the end of a class period to gain an understanding of what students understood from the day’s lecture and what content areas could use additional attention.
At the end of a unit or semester, instructors may create a summative assessment with CJE questions that cover the content and/or skills taught during that time period. Like the formative assessments, the summative exams give students more practice with clinical judgment questions and new item types, all while familiarizing students with the kind of digital testing environment they’ll encounter during the Next Generation NCLEX.
How Does the CJE Build-Your-Own Question Bank Help Nurse Educators?
When the NCSBN announced the Next Generation NCLEX, many nurse educators realized that they were going to have to write new questions to prepare their students for the exam. With the CJE Build-Your-Own Question Bank, powered exclusively by ExamSoft, nurse educators gain access to expertly developed questions, centrally stored within the ExamSoft platform, so they can spend less time creating exams and devote more time to teaching.
With auto-grading, exam results are available almost immediately, and educators gain instant access to automated reports that reveal performance trends for the course, as well as individual students.
Each specialty Build-Your-Own Question Bank includes NextGen unfolding case studies and stand-alone NextGen items (20% of each question bank).
CJE in Action
Since implementing ExamSoft and CJE, The University of Toledo – College of Nursing has been able to enhance their approach to NCLEX readiness and gain key performance insights to help prepare students for exam day. “We’re ahead of the game on the NCLEX Next Gen because we have ExamSoft,” says Dr. Holly Myers, Instructor in the GEM program at The University of Toledo College of Nursing.
CJE Build-Your-Own Question Bank for New Nurse Educators
Nurses who have recently transitioned from the clinical setting to the academic setting may find their new role difficult at first. After all, nursing school and practice did not teach them pedagogy, and there is a lot to learn. Writing valid and reliable exam items, for instance, can be difficult for even the most experienced nurse educators.
New nurse educators may use older exam items as a start. But these items may not cover clinical judgment and most likely won’t be aligned with the Next Generation NCLEX. These questions may also be available to students online or elsewhere, which can make it difficult to maintain academic integrity. CJE removes both of these concerns.
Written by nurse educators and clinicians, and continually analyzed by nurses in the field, the questions included with the CJE Build-Your-Own Question Bank are focused on clinical judgment and developed in alignment with the Next Generation NCLEX.
CJE Build-Your-Own Question Bank from NurseThink® and ExamSoft
The CJE Build-Your-Own Question Bank covers up to 15 focus areas, including a Next Generation NCLEX Readiness exam. Nurse educators can use these to supplement their own exam items or arrange them to fit their needs. CJE questions focus on clinical judgment and aid both experienced nurse educators as well as those new to the classroom.
Because CJE is only available through ExamSoft’s secure, digital platform, test items are safe from integrity breaches, maintaining exam validity. Activating complete device control prevents access to external programs, screensavers, and web browsers — everything but the test itself — while an exam is in session.
CJE questions are categorized in accordance with the NCLEX Client Needs, QSEN, and Clinical Judgment Measurement Model (CJMM). Strengths & Opportunities Reports from ExamSoft break down student performance by each of these categories, giving educators actionable insights to provide targeted remediation, adjust teaching methods, and fill gaps in curriculum — all with the focus of improving Next Generation NCLEX pass rates and, ultimately, patient care.
Contact us for more information on the CJE Build-Your-Own Question Bank from NurseThink® and ExamSoft.