NCSBN Clinical Judgment Measurement Model

The NCSBN Clinical Judgment Measurement Model (NCJMM) was developed by NCSBN researchers as a framework for the valid measurement of clinical judgment and decision making within the context of a standardized, high-stakes examination. While clinical judgment and decision-making have been important element in most prelicensure education programs for many years, significant research and development were required to isolate and measure these traits with psychometric rigor. 

To create the NCJMM, NCSBN researchers drew upon the prevailing literature in nursing, nurse pedagogy, cognitive psychology, psychological assessment, and decision science in addition to conducting multiple investigations involving data from more than 200,000 NCLEX candidates. The result of this work was an evidence-based framework for developing, classifying, and scoring test items that was not only technologically attainable but feasible within the current computerized adaptive testing paradigm of the NCLEX.

The diagram below illustrates the "layers" of the NCJMM, with Layer 3 being particularly pertinent to the development of test items and case studies for the Next Generation exam and Layer 4 providing added contextual elements. More detailed information can be found in various research publications including the Journal of Applied Testing Technology, 2019 Special Issue on Assessment in Medical Education.

NCSBN Nurses

While the NCJMM neither defines nor redefines clinical judgment, it allows NCSBN (and potentially other users) for the first time a method for measuring and deriving valid inferences around the nursing clinical judgment and decision-making ability of prospective entry-level nurses.