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NCLEX UPDATE as of May 2003

May 9, 2003

[ NCLEX News ] Click here for most recent NCLEX PASSING RATE News.

Dear Colleague,

In an attempt to dispel inaccurate rumors that have recently circulated among the nursing community, we
write to you at this time to share some important information regarding the latest program developments
that influence the operations of the National Council Licensure Examinations (the NCLEX-RN® and
NCLEX-PN® examinations). The following five topics have been identified by NCSBN as ‘essential’
issues that you should be informed about to assist in preparing candidates to take the NCLEX
examinations:

Alternative Item Formats

As part of the continuous quality improvement process of the NCLEX program, the NCSBN Examination
Committee routinely considers how to best assess entry-level nurse competence. This commitment
inspired the introduction of NCLEX using Computerized Adaptive Testing (CAT) in 1994 and has
influenced the decision to introduce alternate items (previously known as innovative items and “Next
Generation” NCLEX items) on the NCLEX examinations in 2003.

NCSBN first presented information on alternate items to boards of nursing at the NCSBN Annual Meeting
in 1999 and a demonstration of some of the potential item formats was conducted. The reports of the
NCSBN Examination Committee at the 2000 and 2001 NCSBN Annual Meetings provided updates on a
pilot study using alternate item formats. In addition, NCSBN has provided information on the introduction
of alternative item formats through a number of different print and electronic media outlets since 2000.

An alternate item format is an examination item that takes advantage of new technology and uses a
format other than standard, four-option, one correct response multiple-choice items to assess candidate
ability. Alternate item formats may include: Multiple-choice items that require a candidate to select one or
more responses, fill-in-the-blank items (including calculation and prioritization item types), or items asking
a candidate to identify an area on a picture or graphic. It is important to note that all NCLEX item formats,
including current standard multiple-choice items, may include charts, tables, or graphic images. The
intent of these new, alternate item formats is to assess candidate ability in a manner more efficient and
with more fidelity than can be achieved with standard multiple-choice items.

The introduction of alternative item formats on April 1, 2003, was for purposes of pre-testing the quality of
these new formats. As with all standard NCLEX items, it is required that alternate items be pre-tested
before becoming part of the operational (scored) part of the examinations. This is done in order to gather
‘real’ statistical information on all newly developed items. As with multiple-choice items, alternate items
have to meet NCSBN’s stringent statistical criteria before they can be used as operational items. The
current investigation by the Examination Committee is designed to assess if these new item formats can
accomplish these objectives and the collection of real data is necessary to that end. If items utilizing
these formats meet NCSBN’s selection criteria, these items will be placed in operational item pools
beginning as soon as October 2003.

Currently, there is no requirement in the NCLEX-RN Test Plan (current and proposed) that candidates will
receive a fixed percentage of items with alternate formats. Initially, less than two percent of the items in
an operational pool will be of the alternate item format type. This indicates that a candidate who takes a
minimum length exam, which is the majority of NCLEX reference group candidates, on average may be
administered one operational item of the alternate format.

NCSBN’s Examination Committee will continue to monitor the roll out of these new item types and
provide reports on all aspects of NCLEX item development to all stakeholders as part of its ongoing
charge to continuously improve development of the NCLEX examinations. To stay informed on the
introduction of alternate item formats into NCLEX item pools, please visit the Frequently Asked Questions
(FAQ) document on our home page (www.ncsbn.org). The FAQ is frequently updated and contains the
most complete information on the new item formats.

Proposed NCLEX-RN? Test Plan

At its January 2003 business meeting the Examination Committee reviewed the results of the Report of
Findings from the 2002 RN Practice Analysis: Linking the NCLEX-RN® Examination to Practice, Smith &
Crawford, 2003. Based on empirical data from this practice analysis study, expert opinion of the
Examination Committee and NCSBN staff, the committee recommended changes in the structure and
content distribution of the NCLEX-RN Test Plan. A draft of the revised NCLEX-RN Test Plan was
distributed to all Member Boards of Nursing, the Practice Analysis Panel of Experts, and NCSBN legal
counsel in January 2003 for feedback on the proposed changes. Additionally, information about the
recommended changes was presented at the 2003 NCSBN Midyear Meeting. During its April business
meeting, the Examination Committee considered all feedback and a final draft of the proposed NCLEXRN
Test Plan was developed for presentation to and approval by the NCSBN Delegate Assembly in
August 2003.

After consulting with various stakeholders the committee determined that if the new NCLEX-RN Test Plan
is approved at the 2003 NCSBN Annual Meeting, it will be available free of charge electronically for
download or in hard copy for purchase via the NCSBN Web site (www.ncsbn.org) in Fall 2003.
Forthcoming information on the availability of the new NCLEX-RN Test Plan will be disseminated to
Member Boards of Nursing, nursing educators, and candidates via the NCSBN Web site and publications
as soon as it becomes available after the NCSBN Annual Meeting August 5-8th, 2003. If adopted, it is
expected that implementation of the new NCLEX-RN Test Plan will occur in April 2004.

Investigation of the Current NCLEX-RN® Examination Passing Standard

It is necessary to re-evaluate the appropriateness of the passing standard for the entry-level nurse
licensure examinations on a regular basis because the practice of nursing evolves and changes over
time. To ensure that the passing standard for the NCLEX-RN and NCLEX-PN examinations accurately
reflects the amount of nursing ability currently required to practice safely and competently, the evaluation
of the passing standard is coordinated with the three-year cycle of test plan content evaluation, conducted
using a practice analyses of entry-level RNs. This three-year cycle was developed to keep the test
content and passing standard current with entry-level practice.

The current evaluation cycle for the NCLEX-RN will commence fall 2003. The NCSBN Board of Directors
will use multiple sources of information to guide its evaluation and discussion regarding the establishment
of the passing standard. NCSBN will convene a panel of nine nurses to perform a criterion-referenced
standard setting procedure. Members of this panel will represent the four NCSBN geographical areas,
various nursing specialties, different minority groups, educators who work directly with entry-level RNs,
and one member will represent the newly licensed RN population. In addition to the recommendations of
the panel, the results from a survey of nursing professionals including nursing educators, directors of
nursing in acute care settings, and administrators of long-term care facilities will be evaluated. After
considering all available information, the NCSBN Board of Directors will establish the standard for the
NCLEX-RN that reflects the level of knowledge, skills, and abilities required for safe and effective entry level
RN practice in the United States.

The current passing standard is -0.3500 logits on the NCLEX-RN scale, which translated into a pass rate
of 86.7% for First-Time, U.S. Educated Candidates during 2002. Although it is too soon to know whether
the passing standard will be raised, lowered, or maintained, it is anticipated that the decision will affect
the pass rates of the NCLEX-RN examination for the duration of the following three year cycle. It is
projected that if the passing standard is lowered or maintained, the pass rate will increase and
conversely, if the standard is increased, the pass rate will decrease. Regardless of the decision made by
the NCSBN Board of Directors, information regarding the decision will be communicated to Boards of
Nursing, nursing education programs and other NCLEX stakeholders as soon as possible after the Board
establishes the new standard in November 2003. It is expected that the establishment of any standard
will be employed coincident with the implementation of the new NCLEX-RN Test Plan in April 2004.

Exclusive NCLEX Examination Registration with Pearson VUE

As of August 15, 2002, The Chauncey Group International, NCLEX test service since 1994, ceased
accepting registrations for the NCLEX examination. Between August 15, 2002 and the present, the
NCSBN Testing Services Department has received and returned more than 4,000 candidate registrations
and fees which were mailed to Chauncey in error. While NCSBN Testing Services does return these
registrations and fees to candidates in a timely manner, candidates are nevertheless delayed in
registering for the NCLEX examination.

We take this opportunity to remind all NCLEX stakeholders that Chauncey NCLEX Examination
Candidate Bulletins cannot be used for NCLEX examination registrations. It is suggested that if
candidates require a new Pearson VUE NCLEX Examination Candidate Bulletin that they contact their
prospective board of licensure to obtain one. To take advantage of the speed of the new Pearson VUE
administration system it is recommended that candidates use the electronic copy of the bulletin found on
the NCSBN Web site (www.ncsbn.org). The instructions on how to register with Pearson VUE by
telephone or through the Internet are provided in the bulletin. Either of these methods allows a candidate
to register and take the examination sooner than if they were to register by mail.

NCLEX Invitational 2003

NCSBN invites you to join us in Boston for the fourth annual NCLEX Invitational Friday, September 26,
2003. This year’s agenda will focus on the NCLEX Program one year after partnering with the new
NCLEX test service provider, Pearson VUE. Sample program content includes: Internet based
examination registration and scheduling, the new NCLEX-RN Test Plan, a review of the NCLEX passing
standard setting process, newly developed alternate item formats and future initiatives for the NCLEX
Program. In addition, an interactive session explaining NCLEX Results Reporting: From the importance
of Program Codes to the Candidate Performance Report (CPR) will be conducted. As in past years, the
NCLEX Invitational will provide invaluable information for boards of nursing, nursing educators, nurse
recruiters, NCLEX review courses, and representatives from professional nursing organizations.
Continuing education credits will be awarded. Please visit the Events portion of the NCSBN Web site at
www.ncsbn.org to register.

Although this letter is designed to inform you of recent developments, as always, the most current and
complete information about the National Council of State Boards of Nursing and the NCLEX examinations
is available from our Web site at www.ncsbn.org, e-mail at nclexinfo@ncsbn.org or by phone toll-free at
1.866.293.9600. Please feel free to contact us with your comments, questions, and concerns.

Sincerely,

Donna Dorsey, MS, RN
Kathy Apple, MS, RN
President Executive Director
National Council of State Board of Nursing, Inc. National Council of State Board of Nursing, Inc.

Casey Marks, PhD
Director of Testing Services
National Council of State Board of Nursing, Inc.


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