WEBVTT 00:00:07.100 --> 00:00:10.640 position:50% align:middle Welcome, everyone, to this presentation. 00:00:10.640 --> 00:00:14.740 position:50% align:middle I want to give you some updates on the Next Generation NCLEX. 00:00:14.740 --> 00:00:18.862 position:50% align:middle You'll all know, many of you will know, it's a journey that started many years ago, 00:00:18.862 --> 00:00:26.908 position:50% align:middle around 2012, and we got some exciting updates to give you and a look at what success 00:00:26.908 --> 00:00:27.589 position:50% align:middle might look like. 00:00:27.589 --> 00:00:32.889 position:50% align:middle So if you'll come along in the journey with me through this presentation, we'll be giving you some 00:00:32.889 --> 00:00:38.492 position:50% align:middle updates on just exactly where we're at right now with our research, what the item development 00:00:38.492 --> 00:00:43.070 position:50% align:middle looks like at this point, scoring, how much we're going to score these models, 00:00:43.070 --> 00:00:49.617 position:50% align:middle testing, design, what the actual overall exam might look like. And finally, how we're going to do beta 00:00:49.617 --> 00:00:54.870 position:50% align:middle testing so that we can assure every one of you, one, that we can launch this safely, and two, 00:00:54.870 --> 00:01:00.807 position:50% align:middle that we can provide the best measurement that has become the hallmark of NCSBN and the 00:01:00.807 --> 00:01:06.550 position:50% align:middle NCLEX, and we can do that both with psychometric and legal defensibility. 00:01:06.550 --> 00:01:08.710 position:50% align:middle So where are we now? 00:01:08.710 --> 00:01:12.210 position:50% align:middle Well, the first place is we've already done this. 00:01:12.210 --> 00:01:14.170 position:50% align:middle The green check mark tells you it's completed. 00:01:14.170 --> 00:01:18.190 position:50% align:middle We developed a clinical-judgment measurement model, we published a great deal of information 00:01:18.190 --> 00:01:21.660 position:50% align:middle on this through 2014, '15, and '16. 00:01:21.660 --> 00:01:27.200 position:50% align:middle And during that same time period, we started developing item prototypes. 00:01:27.200 --> 00:01:29.220 position:50% align:middle What could items look like? 00:01:29.220 --> 00:01:34.800 position:50% align:middle If you were to remember, the NCLEX currently has multiple response items and 00:01:34.800 --> 00:01:36.310 position:50% align:middle multiple choice items. 00:01:36.310 --> 00:01:44.457 position:50% align:middle We found early on after developing the model that those particular items, one, could not measure, at 00:01:44.457 --> 00:01:51.751 position:50% align:middle its best, the concepts and the various elements of clinical judgment like cue recognition 00:01:51.751 --> 00:01:53.590 position:50% align:middle versus hypothesis generation. 00:01:53.590 --> 00:01:56.854 position:50% align:middle And so we have started developing item prototypes. 00:01:56.854 --> 00:02:01.722 position:50% align:middle And I'm going to show you where we've ended up on that and what new items might look like as 00:02:01.722 --> 00:02:03.470 position:50% align:middle they appear on the NCLEX. 00:02:03.470 --> 00:02:10.020 position:50% align:middle We also created a great deal of due diligence around, how usable are the items? 00:02:10.020 --> 00:02:15.880 position:50% align:middle And I don't mean just usable from a psychometric perspective or can they actually be scored, 00:02:15.880 --> 00:02:23.440 position:50% align:middle we know that too, but could individuals sit in front of a screen, look at one of these items, 00:02:23.440 --> 00:02:27.850 position:50% align:middle and actually know how to answer it because they're a little more complex. 00:02:27.850 --> 00:02:34.089 position:50% align:middle And so we did a significant amount of research, one-on-one with individuals and a talk aloud 00:02:34.089 --> 00:02:39.780 position:50% align:middle protocol to get input on what a item should look like, what the instructions should look like, 00:02:39.780 --> 00:02:47.470 position:50% align:middle what the screen should look like, and we incorporated all of that in, created a set of items, 00:02:47.470 --> 00:02:49.620 position:50% align:middle and started what we're doing right now. 00:02:49.620 --> 00:02:53.500 position:50% align:middle And you can see I've done that check mark right there, this is in progress. 00:02:53.500 --> 00:02:56.330 position:50% align:middle And so we're doing item data collection right now. 00:02:56.330 --> 00:03:03.439 position:50% align:middle I tell you some very interesting things about item collection that has surprised me and, in some 00:03:03.439 --> 00:03:11.617 position:50% align:middle cases, astounded me, but we started item collection 18 months ago, maybe 24 months ago 00:03:11.617 --> 00:03:24.358 position:50% align:middle by now, and we've had over 600,000 RNs actually participate in the special research section that we 00:03:24.358 --> 00:03:25.946 position:50% align:middle added to the end of the NCLEX. 00:03:25.946 --> 00:03:28.400 position:50% align:middle That really is an amazing number. 00:03:28.400 --> 00:03:33.260 position:50% align:middle What it allowed us to do was, then, to get a much larger sample, a lot more data. 00:03:33.260 --> 00:03:40.427 position:50% align:middle Now, it also allowed us to develop, what I call, the motivation index in which we knew some of these 00:03:40.427 --> 00:03:48.600 position:50% align:middle six hundred-plus thousand nurses, RNs, that took this just wanted to see the items, and they 00:03:48.600 --> 00:03:50.230 position:50% align:middle weren't really interacting. 00:03:50.230 --> 00:03:56.390 position:50% align:middle But I can tell you, we know that over 340,000 of those completed every single item, 00:03:56.390 --> 00:04:00.900 position:50% align:middle passed what we created as a statistical-motivation test. 00:04:00.900 --> 00:04:06.600 position:50% align:middle And so as a minimum, every one of those participated in 10 items 00:04:06.600 --> 00:04:09.560 position:50% align:middle at a minimum, at a maximum, 22 items. 00:04:09.560 --> 00:04:15.302 position:50% align:middle Some quick math tells you that we have data points to analyze for more than 00:04:15.302 --> 00:04:17.843 position:50% align:middle 3.4 million data points. 00:04:17.843 --> 00:04:19.230 position:50% align:middle That is pretty amazing. 00:04:19.230 --> 00:04:22.810 position:50% align:middle It's allowed us to do some really great work with 00:04:22.810 --> 00:04:28.650 position:50% align:middle the staff, the psychometric team, the content team just have been amazing in the 00:04:28.650 --> 00:04:29.510 position:50% align:middle work around this. 00:04:29.510 --> 00:04:35.454 position:50% align:middle And so that allowed us to get to measurement research, start thinking about how do you score 00:04:35.454 --> 00:04:43.624 position:50% align:middle this, can we score them, what are the impacts around various scoring categories and those sort 00:04:43.624 --> 00:04:46.140 position:50% align:middle of things, and we'll talk a little bit about that. 00:04:46.140 --> 00:04:50.870 position:50% align:middle We're also, all of these last three, you can see the check marks are in progress now. 00:04:50.870 --> 00:04:56.480 position:50% align:middle We're now building, working with our vendor, Pearson VUE, right now to build the technology 00:04:56.480 --> 00:05:00.850 position:50% align:middle that will allow us to launch this exam because we don't want to change anything. 00:05:00.850 --> 00:05:06.060 position:50% align:middle The ability to deliver an item in the same amount of time as the old NCLEX items, 00:05:06.060 --> 00:05:14.925 position:50% align:middle the ability to deliver these items and simultaneously in the same exam, deliver NCLEX 00:05:14.925 --> 00:05:22.000 position:50% align:middle items, the ability to get scoring out of this in real time, so we don't slow any of the processes that 00:05:22.000 --> 00:05:25.440 position:50% align:middle have been the hallmark of the NCLEX exam for a number of years. 00:05:25.440 --> 00:05:31.478 position:50% align:middle And finally, we're going to be talking about the alpha/beta testing which hasn't started, but I'll give 00:05:31.478 --> 00:05:33.750 position:50% align:middle you a lot more information a little bit later on. 00:05:33.750 --> 00:05:38.630 position:50% align:middle The item development, where are we at is that we know a few things 00:05:38.630 --> 00:05:40.010 position:50% align:middle about item development. 00:05:40.010 --> 00:05:48.129 position:50% align:middle First, the clinical judgment on the new exam on NGN, Next Generation NCLEX, will be measured 00:05:48.129 --> 00:05:48.823 position:50% align:middle in two ways. 00:05:48.823 --> 00:05:55.260 position:50% align:middle Two ways are case studies, which are basically real-world scenarios accompanied 00:05:55.260 --> 00:05:57.950 position:50% align:middle by different test items. 00:05:57.950 --> 00:06:01.110 position:50% align:middle So what I'm getting at, and I'll show you a little bit after this slide, 00:06:01.110 --> 00:06:09.990 position:50% align:middle is that we're going to go back and follow a client through a case much like a nurse would do 00:06:09.990 --> 00:06:11.080 position:50% align:middle in the real world. 00:06:11.080 --> 00:06:15.886 position:50% align:middle So we're calling them case studies but ultimately, real-world scenarios, and we'll be able to measure 00:06:15.886 --> 00:06:19.420 position:50% align:middle those as a whole case in the individual item. 00:06:19.420 --> 00:06:22.520 position:50% align:middle The other thing that's going to happen is there will be standalone items. 00:06:22.520 --> 00:06:28.656 position:50% align:middle Now, standalone items means that we're not able to measure the entire clinical-judgment model, but 00:06:28.656 --> 00:06:33.700 position:50% align:middle we're able to measure portions of it throughout the remaining exam. 00:06:33.700 --> 00:06:39.597 position:50% align:middle So it just adds more data to what we're looking at in terms of getting a valid and reliable 00:06:39.597 --> 00:06:42.080 position:50% align:middle measurement at the end of the exam. 00:06:42.080 --> 00:06:43.260 position:50% align:middle Here's how it kind of looks. 00:06:43.260 --> 00:06:47.974 position:50% align:middle When you're measuring clinical judgment, standalone items are going to target one or more 00:06:47.974 --> 00:06:51.860 position:50% align:middle of the six layers of the clinical-judgment model. 00:06:51.860 --> 00:06:56.700 position:50% align:middle We don't have it here, but over the last several years, I've talked about this clinical-judgment model 00:06:56.700 --> 00:06:59.650 position:50% align:middle that had different layers, and we were going to focus on Layer 3. 00:06:59.650 --> 00:07:05.090 position:50% align:middle So what I've cut out here, this is Layer 3, and this is what you would call the action model or the 00:07:05.090 --> 00:07:09.950 position:50% align:middle measurement model, meaning we need to be able to measure, recognize queues, analyze queues, 00:07:09.950 --> 00:07:15.200 position:50% align:middle prioritize hypotheses, generate solutions, take actions, and evaluate outcome. 00:07:15.200 --> 00:07:19.920 position:50% align:middle And what I'm getting at is a standalone item won't measure all of those, but it will measure one or 00:07:19.920 --> 00:07:21.250 position:50% align:middle more of those. 00:07:21.250 --> 00:07:28.300 position:50% align:middle The case study, it'll target multiple of those, in fact, it will target six of those, 00:07:28.300 --> 00:07:32.591 position:50% align:middle maybe all six of those, maybe a repeat of three of those, but the idea is 00:07:32.591 --> 00:07:38.170 position:50% align:middle there's a case study, and you imagine in any case, you may have iterations where you go from 00:07:38.170 --> 00:07:43.882 position:50% align:middle recognize cues to analyze cues, and then you have to go back to recognizing more cues, but it will be 00:07:43.882 --> 00:07:47.600 position:50% align:middle a fidelity situation that can measure any of those six. 00:07:47.600 --> 00:07:51.420 position:50% align:middle Every case study will, in fact, have six items in it. 00:07:51.420 --> 00:07:54.840 position:50% align:middle And what would those look like? 00:07:54.840 --> 00:07:59.250 position:50% align:middle Well, I've put it in an example in today's presentation, so I can give you an idea. 00:07:59.250 --> 00:08:02.410 position:50% align:middle Now, the point of this, when I start showing you this sample, 00:08:02.410 --> 00:08:04.700 position:50% align:middle is to show you how the items might look. 00:08:04.700 --> 00:08:11.186 position:50% align:middle This is not an item that will ever appear on the exam now because it's compromised by showing it 00:08:11.186 --> 00:08:17.110 position:50% align:middle to you, but the point is, I want you to take a close look at how they're designed. 00:08:17.110 --> 00:08:24.430 position:50% align:middle This isn't a time for me to stop and debate the words in the item, but if you want to do that, 00:08:24.430 --> 00:08:28.396 position:50% align:middle you can probably pause this video and read through it a little closer, but the point I want to 00:08:28.396 --> 00:08:31.790 position:50% align:middle show to you here is what items might look like. 00:08:31.790 --> 00:08:35.480 position:50% align:middle And so if you had a case study, you can see this week case study, 00:08:35.480 --> 00:08:40.610 position:50% align:middle this would be the first screen of six screens that the candidate is going to see, and we tell them that. 00:08:40.610 --> 00:08:45.750 position:50% align:middle You'll notice that what happens, and like a regular NCLEX item, is we start out and say, 00:08:45.750 --> 00:08:50.720 position:50% align:middle the nurse is caring for a client, in this case, a 78-year-old female. 00:08:50.720 --> 00:08:54.300 position:50% align:middle And we tell them the context, the environment, they're in the ED. 00:08:54.300 --> 00:08:55.840 position:50% align:middle With that, they have the setup. 00:08:55.840 --> 00:08:59.700 position:50% align:middle And now, we start giving them a client care report. 00:08:59.700 --> 00:09:01.180 position:50% align:middle So you'll see these tabs. 00:09:01.180 --> 00:09:05.340 position:50% align:middle Important thing to point out here, this one has one tab in it because only one 00:09:05.340 --> 00:09:06.400 position:50% align:middle thing has happened. 00:09:06.400 --> 00:09:08.100 position:50% align:middle This tab could grow. 00:09:08.100 --> 00:09:11.880 position:50% align:middle It could include lab results, there'd be a tab for lab results, 00:09:11.880 --> 00:09:17.250 position:50% align:middle a tab for vital signs, a tab for… So it's basically a progression of the 00:09:17.250 --> 00:09:21.300 position:50% align:middle client's history through the case, and it just continues on through it. 00:09:21.300 --> 00:09:25.820 position:50% align:middle So as you look at this, always on the left side of the screen as you look 00:09:25.820 --> 00:09:30.740 position:50% align:middle at it, will be the information about the client or the client care record. 00:09:30.740 --> 00:09:35.380 position:50% align:middle On the right side, will be the actions required by the candidate to answer the questions. 00:09:35.380 --> 00:09:38.230 position:50% align:middle So they read through the nursing note, they can see it was at 10:00, 00:09:38.230 --> 00:09:42.400 position:50% align:middle they know it's in the emergency department, they know it's a 78 female, 00:09:42.400 --> 00:09:47.570 position:50% align:middle and they are now asked to select the four findings that require immediate follow up. 00:09:47.570 --> 00:09:53.400 position:50% align:middle So they have to read through this nursing note and define, out of those six, 00:09:53.400 --> 00:09:57.120 position:50% align:middle which four required immediate follow up. 00:09:57.120 --> 00:10:01.800 position:50% align:middle So basically, you can see this is a close-up view, and I'm going to go into this now. 00:10:01.800 --> 00:10:04.940 position:50% align:middle Sorry, I know this is repeat, but I want to go into it because the rest of the screens, 00:10:04.940 --> 00:10:07.950 position:50% align:middle I'm not going to show you split screens, I'm going to show it to you like this. 00:10:07.950 --> 00:10:12.611 position:50% align:middle So this is a close-up view of what's on the left-hand side of your screen, we just 00:10:12.611 --> 00:10:13.343 position:50% align:middle talked about it. 00:10:13.343 --> 00:10:16.640 position:50% align:middle This is what a close-up view of the right hand would see. 00:10:16.640 --> 00:10:20.320 position:50% align:middle Now, your candidate sees both of them side by side, but I want you to see them this way. 00:10:20.320 --> 00:10:23.450 position:50% align:middle The second one, remember, the tab hasn't changed now. 00:10:23.450 --> 00:10:26.400 position:50% align:middle So I'm showing you a close-up view of the second item. 00:10:26.400 --> 00:10:31.296 position:50% align:middle And so for the information that was in that nurse's notes, now they're being asked for each client 00:10:31.296 --> 00:10:33.330 position:50% align:middle finding, and we give them the finding. 00:10:33.330 --> 00:10:34.270 position:50% align:middle Those were in there. 00:10:34.270 --> 00:10:35.430 position:50% align:middle They can read about those. 00:10:35.430 --> 00:10:39.100 position:50% align:middle These existed, fever, confusion, body soreness, you see them there. 00:10:39.100 --> 00:10:45.066 position:50% align:middle We now ask them that they have to click to specify the findings that are consistent with the disease 00:10:45.066 --> 00:10:49.380 position:50% align:middle process of pneumonia, urinary tract infection, or influenza. 00:10:49.380 --> 00:10:52.330 position:50% align:middle So now they're evaluating the clues. 00:10:52.330 --> 00:10:55.730 position:50% align:middle So they have a fever, they're going to have to suggest to you, 00:10:55.730 --> 00:10:58.870 position:50% align:middle is fever indicative of pneumonia, UTI, or influenza? 00:10:58.870 --> 00:11:03.570 position:50% align:middle This is a little different from a regular NCLEX where they could only answer one of those. 00:11:03.570 --> 00:11:07.150 position:50% align:middle And here, they can answer any one of those. 00:11:07.150 --> 00:11:10.720 position:50% align:middle So each finding may support one or more disease process. 00:11:10.720 --> 00:11:14.930 position:50% align:middle So fever, pneumonia, you'd click it, UTI, click it, influenza, click it. 00:11:14.930 --> 00:11:19.630 position:50% align:middle So they click all three of those whereas as they go down on some of these other ones, 00:11:19.630 --> 00:11:22.670 position:50% align:middle they may only click pneumonia, they may only click UTI. 00:11:22.670 --> 00:11:27.012 position:50% align:middle What they have to do in this one, as you'll note at the bottom, each column must have at 00:11:27.012 --> 00:11:28.436 position:50% align:middle least one response. 00:11:28.436 --> 00:11:30.934 position:50% align:middle So they got to have one response in each column. 00:11:30.934 --> 00:11:33.060 position:50% align:middle They could leave the rows blank. 00:11:33.060 --> 00:11:35.920 position:50% align:middle They're not required to answer everything. 00:11:35.920 --> 00:11:42.050 position:50% align:middle This item, we would call a matrix item, obviously, because it's a 3 by 5 matrix. 00:11:42.050 --> 00:11:44.600 position:50% align:middle They can answer any of the items in that matrix. 00:11:44.600 --> 00:11:46.240 position:50% align:middle This, we call a cloze item. 00:11:46.240 --> 00:11:50.360 position:50% align:middle I like to think of this item, really, as not particularly new. 00:11:50.360 --> 00:11:54.350 position:50% align:middle It's new in measurement and the ability to measurement but the item type is not. 00:11:54.350 --> 00:12:01.190 position:50% align:middle This item, at least for me, came into my world when I started reading highlight 00:12:01.190 --> 00:12:06.549 position:50% align:middle magazines and reading…there was always an article on "Goofus and Gallant" and you had to 00:12:06.549 --> 00:12:07.467 position:50% align:middle finish the story. 00:12:07.467 --> 00:12:12.900 position:50% align:middle So you'd start reading along and you'd come along some activity that you'd have to pick whether 00:12:12.900 --> 00:12:18.157 position:50% align:middle Goofus or Gallant did it, and then you would read along and you'd have to say what happened 00:12:18.157 --> 00:12:21.630 position:50% align:middle because Goofus did it, this happened because Gallant did... 00:12:21.630 --> 00:12:28.040 position:50% align:middle You got to write the story in some ways, but you had to select one and it impacted the other. 00:12:28.040 --> 00:12:33.180 position:50% align:middle So if you've selected Goofus, you needed to actually respond on the outcome based 00:12:33.180 --> 00:12:35.140 position:50% align:middle on what would happen with Goofus versus Gallant. 00:12:35.140 --> 00:12:37.860 position:50% align:middle So this is the same sort of thing but we figured out how to measure. 00:12:37.860 --> 00:12:41.550 position:50% align:middle So you go, the client is at the highest risk for developing something, 00:12:41.550 --> 00:12:45.320 position:50% align:middle and I'm going to show you another slide to get to that, as evidenced by. 00:12:45.320 --> 00:12:51.800 position:50% align:middle So you're setting up an analysis of the risk and the evidence that supports that, this, the way 00:12:51.800 --> 00:12:53.400 position:50% align:middle clinical thinking works. 00:12:53.400 --> 00:12:57.730 position:50% align:middle So in this case, the client has the highest risk for developing, and then you get to select hypoxia, 00:12:57.730 --> 00:13:04.400 position:50% align:middle stroke, dysrhythmia, or an embolism, and then they have to select, based on whichever one 00:13:04.400 --> 00:13:10.433 position:50% align:middle they picked, what were the client's signs that actually indicated that. 00:13:10.433 --> 00:13:12.540 position:50% align:middle So you can see it's sort of a two part. 00:13:12.540 --> 00:13:18.120 position:50% align:middle Now the interesting thing about this, we could have gone on two more or three more, right? 00:13:18.120 --> 00:13:22.630 position:50% align:middle So this doesn't have to stop in one risk and evidence. 00:13:22.630 --> 00:13:25.924 position:50% align:middle The story could have went on, and they would have to answer more of these, but they're always 00:13:25.924 --> 00:13:27.250 position:50% align:middle connected one to two. 00:13:27.250 --> 00:13:33.050 position:50% align:middle All right, so it's a cloze, what we call a cloze, C-L-O-Z-E, item. 00:13:33.050 --> 00:13:38.989 position:50% align:middle Now, what happens in the fourth item is this…you can see at the top, the nurse is still caring for the 00:13:38.989 --> 00:13:44.320 position:50% align:middle same client in the same place, but it's two hours later and there's more information. 00:13:44.320 --> 00:13:47.800 position:50% align:middle The nurse has now reviewed the nurse's note entries for 10 and 12. 00:13:47.800 --> 00:13:51.670 position:50% align:middle So it's sort of a cue, you probably ought to have read that, 00:13:51.670 --> 00:13:53.190 position:50% align:middle and they're planning the care. 00:13:53.190 --> 00:13:57.230 position:50% align:middle So they need to now talk about for each potential nursing intervention, 00:13:57.230 --> 00:14:00.600 position:50% align:middle click whether it's indicated or contraindicated. 00:14:00.600 --> 00:14:06.240 position:50% align:middle So here are your potential interventions, and the candidate has to determine is this indicated, 00:14:06.240 --> 00:14:09.750 position:50% align:middle would it be appropriate, would it be contraindicated, inappropriate? 00:14:09.750 --> 00:14:15.385 position:50% align:middle You go on to the next question and you see that the nurses reviewed the orders for 12:15, so 00:14:15.385 --> 00:14:18.818 position:50% align:middle there'll be orders for 12:15, and they're to click on the three orders that they should 00:14:18.818 --> 00:14:19.956 position:50% align:middle perform right away. 00:14:19.956 --> 00:14:25.270 position:50% align:middle And so they're told that they have these orders to give, now, which one or what priority are those 00:14:25.270 --> 00:14:29.910 position:50% align:middle given in, and they do this in a different way by highlighting. 00:14:29.910 --> 00:14:35.147 position:50% align:middle So this is really an interesting item because you're seeing it this way, but you could also just have an 00:14:35.147 --> 00:14:39.074 position:50% align:middle open paragraph where they have to highlight sentences actually in the nursing note 00:14:39.074 --> 00:14:39.820 position:50% align:middle to answer this. 00:14:39.820 --> 00:14:45.125 position:50% align:middle So there's a variety of way this one can work, but I wanted to show you in a simple way where they 00:14:45.125 --> 00:14:50.640 position:50% align:middle simply highlight those answers that, in fact, should be performed right away. 00:14:50.640 --> 00:14:52.960 position:50% align:middle And then the sixth and final item looks like this. 00:14:52.960 --> 00:14:58.820 position:50% align:middle The nurse has performed the interventions that they just talked about on the previous answer. 00:14:58.820 --> 00:15:04.960 position:50% align:middle For each assessment finding, they have to click to say, has it gotten better, there's no change, 00:15:04.960 --> 00:15:06.180 position:50% align:middle or it's gotten worse. 00:15:06.180 --> 00:15:10.480 position:50% align:middle This is what we expect of nurses, and we've figured out a way to do this. 00:15:10.480 --> 00:15:14.470 position:50% align:middle So the difference between this matrix item, this got a matrix item again, 00:15:14.470 --> 00:15:17.240 position:50% align:middle but you'll notice it has circles instead of squares. 00:15:17.240 --> 00:15:23.807 position:50% align:middle Because in this item, you look at respiratory rate, 36, it cannot… They can only pick one thing in a 00:15:23.807 --> 00:15:27.660 position:50% align:middle row, meaning that it can't improve and have no change. 00:15:27.660 --> 00:15:28.560 position:50% align:middle So they can only pick one. 00:15:28.560 --> 00:15:32.780 position:50% align:middle So they're forced along this to pick a single answer. 00:15:32.780 --> 00:15:36.250 position:50% align:middle This is what a sample case might look like. 00:15:36.250 --> 00:15:43.370 position:50% align:middle So a candidate is definitely going to get six items, it's going to run through either all six of the Layer 3 00:15:43.370 --> 00:15:51.530 position:50% align:middle boxes in the model, or it is going to use an entry approach and perhaps measure a subset 00:15:51.530 --> 00:15:57.841 position:50% align:middle of those items and revert back to, but the point is, there will be six in the case study, and it will 00:15:57.841 --> 00:16:03.680 position:50% align:middle measure Layer 3 along the action model that I showed earlier. 00:16:03.680 --> 00:16:08.080 position:50% align:middle The items that I highlighted, you saw a highlighted item, a cloze item, 00:16:08.080 --> 00:16:13.830 position:50% align:middle a matrix item, extended response, the trend item is one that, that trends along, 00:16:13.830 --> 00:16:15.820 position:50% align:middle as I was talking about, it has to do with the case study. 00:16:15.820 --> 00:16:17.230 position:50% align:middle It doesn't actually change. 00:16:17.230 --> 00:16:23.170 position:50% align:middle And the extended drag and drop includes a bow tie, which I want to show you now. 00:16:23.170 --> 00:16:26.900 position:50% align:middle The sample standalone is called a bow tie item. 00:16:26.900 --> 00:16:28.220 position:50% align:middle So take a look at this. 00:16:28.220 --> 00:16:30.070 position:50% align:middle This is an item that a candidate would get. 00:16:30.070 --> 00:16:32.530 position:50% align:middle It just pops up in the middle of the exam. 00:16:32.530 --> 00:16:34.120 position:50% align:middle It doesn't have a case attached to it. 00:16:34.120 --> 00:16:36.680 position:50% align:middle The entire case is on the screen right now. 00:16:36.680 --> 00:16:40.883 position:50% align:middle So you take a look at this, you should have the nurse, they're in an emergency department, 00:16:40.883 --> 00:16:45.710 position:50% align:middle remember we got context again, and they're caring for, now, a 79-year-old client, 00:16:45.710 --> 00:16:50.190 position:50% align:middle they have two tabs they need to read, a nurse's note, a history, and a physical. 00:16:50.190 --> 00:16:52.770 position:50% align:middle And then, the question is on this side. 00:16:52.770 --> 00:16:58.049 position:50% align:middle And so basically, if you take a look at this, the nurse is reviewing the client's assessment data, 00:16:58.049 --> 00:17:02.310 position:50% align:middle and they're going to be preparing a care plan. 00:17:02.310 --> 00:17:04.630 position:50% align:middle So they need to create the diagram. 00:17:04.630 --> 00:17:09.590 position:50% align:middle So in the middle, conditions likely…the condition most likely experiencing, 00:17:09.590 --> 00:17:15.510 position:50% align:middle they have to pick from Bell's Palsy, hyperglycemia, ischemic stroke, or urinary tract infection and drag 00:17:15.510 --> 00:17:21.180 position:50% align:middle that condition up to the top where it says, most likely experiencing. 00:17:21.180 --> 00:17:28.100 position:50% align:middle Then from there, they have to go on the left-hand side, pick two of the actions they would take 00:17:28.100 --> 00:17:34.570 position:50% align:middle based on that potential condition, and then take and draw from parameters to monitor what 00:17:34.570 --> 00:17:36.510 position:50% align:middle they should monitor based on those actions. 00:17:36.510 --> 00:17:41.105 position:50% align:middle So you can see this is a bit more complex, but it measures two or three boxes of the 00:17:41.105 --> 00:17:43.680 position:50% align:middle clinical-judgment model in a single item. 00:17:43.680 --> 00:17:50.360 position:50% align:middle I will tell you a little bit more how those are going to get put in the exam later in this presentation. 00:17:50.360 --> 00:17:53.870 position:50% align:middle So let's talk about the status of item development. 00:17:53.870 --> 00:17:54.900 position:50% align:middle What is going on right now? 00:17:54.900 --> 00:17:55.730 position:50% align:middle Where are we at? 00:17:55.730 --> 00:18:01.560 position:50% align:middle So clinical-judgment item sets, we began that work in 2017, and I can tell you, 00:18:01.560 --> 00:18:06.660 position:50% align:middle we're pretty near launch goal of what we would need to launch, and then we would simply continue 00:18:06.660 --> 00:18:07.550 position:50% align:middle to maintain that bank. 00:18:07.550 --> 00:18:09.760 position:50% align:middle So we've been really successful. 00:18:09.760 --> 00:18:13.580 position:50% align:middle The PN work began in January, this January of 2020. 00:18:13.580 --> 00:18:20.580 position:50% align:middle And even through the pandemic and some of the things, we've been able to continue that work. 00:18:20.580 --> 00:18:28.450 position:50% align:middle Our primary focus right now is PN work because, as I said, the RN work is pretty close to launch. 00:18:28.450 --> 00:18:33.090 position:50% align:middle Now, we will have to have a maintenance on that but really exciting that we're doing that. 00:18:33.090 --> 00:18:37.260 position:50% align:middle The clinical-judgment, standalone items are in progress. 00:18:37.260 --> 00:18:42.845 position:50% align:middle So those have not being completely developed, but we are confident we'll be able to do that and 00:18:42.845 --> 00:18:44.760 position:50% align:middle wanted you to see what they might look like. 00:18:44.760 --> 00:18:49.100 position:50% align:middle So ultimately, I can tell you, item development is on track. 00:18:49.100 --> 00:18:51.210 position:50% align:middle Our project plan is in place. 00:18:51.210 --> 00:18:52.520 position:50% align:middle We haven't missed anything. 00:18:52.520 --> 00:18:59.250 position:50% align:middle COVID has not slowed us down, and we are on track to launch in 2023, more importantly, 00:18:59.250 --> 00:19:01.889 position:50% align:middle spring or April of 2023. 00:19:01.889 --> 00:19:04.890 position:50% align:middle What's the scoring going to look like? 00:19:04.890 --> 00:19:08.280 position:50% align:middle So we're going to take a new approach to scoring these items. 00:19:08.280 --> 00:19:14.169 position:50% align:middle You can imagine that the way we've scored items before or today, as we're scoring them actually 00:19:14.169 --> 00:19:18.260 position:50% align:middle today, we score them as either right or wrong or what we call dichotomous. 00:19:18.260 --> 00:19:22.040 position:50% align:middle You either get everything right or you get everything wrong. 00:19:22.040 --> 00:19:28.898 position:50% align:middle And that's worked well for us based on having multiple-choice items with four responses or 00:19:28.898 --> 00:19:32.620 position:50% align:middle multiple-response items with up to maybe six. 00:19:32.620 --> 00:19:37.569 position:50% align:middle The problem with that is if you start looking at what we were calling matrix items and you take a 00:19:37.569 --> 00:19:45.100 position:50% align:middle 3 by 5 matrix, there's a potential of 15 responses in that, and choosing to get all are right or all 00:19:45.100 --> 00:19:54.030 position:50% align:middle wrong has some problems with it both in terms of psychometric fairness and legal defensibility. 00:19:54.030 --> 00:20:01.490 position:50% align:middle So what we've looked at is doing something where we call polytomous scoring, which means there are 00:20:01.490 --> 00:20:04.080 position:50% align:middle more possible categories. 00:20:04.080 --> 00:20:07.730 position:50% align:middle You are not one or zero, either you get it right or wrong, 00:20:07.730 --> 00:20:12.570 position:50% align:middle which suggests that on any item, if one of you get it right and I get it right, 00:20:12.570 --> 00:20:19.460 position:50% align:middle we have equal ability, and if one of us get it wrong or both of us get it wrong, we have no ability. 00:20:19.460 --> 00:20:26.740 position:50% align:middle And we fundamentally know that's not true, but now with the ability to create larger-scoring categories, 00:20:26.740 --> 00:20:34.020 position:50% align:middle we can actually distribute ability across more categories, let's say zero, one, two, three, four, 00:20:34.020 --> 00:20:35.960 position:50% align:middle maybe up to as high as eight categories. 00:20:35.960 --> 00:20:38.990 position:50% align:middle So this is actually a great thing for us. 00:20:38.990 --> 00:20:41.230 position:50% align:middle In fact, what has it done for us? 00:20:41.230 --> 00:20:47.770 position:50% align:middle The ability to partial-credit score has given us higher, what we call inter-item correlations. 00:20:47.770 --> 00:20:48.680 position:50% align:middle What does that mean? 00:20:48.680 --> 00:20:55.049 position:50% align:middle It means actually, we're getting better correlations with our NGN items to the final score of that 00:20:55.049 --> 00:20:58.190 position:50% align:middle candidate than our current NCLEX items are giving us. 00:20:58.190 --> 00:21:04.800 position:50% align:middle So really, probably a very positive thing for us to do, and I'm glad we got there. 00:21:04.800 --> 00:21:09.250 position:50% align:middle I want to tell you, the other thing that we're able to do is, even with this scoring, 00:21:09.250 --> 00:21:15.410 position:50% align:middle we've been able to maintain the 95% decision accuracy that we've required for the NCLEX, 00:21:15.410 --> 00:21:20.630 position:50% align:middle our correlations and reliabilities are staying essentially the same. 00:21:20.630 --> 00:21:27.780 position:50% align:middle So we're gaining a significant amount or, well, we're gaining a certain amount of inter-rater, 00:21:27.780 --> 00:21:33.780 position:50% align:middle inter-item correlations to the final score, adds the credibility, defensibility to the exam, 00:21:33.780 --> 00:21:38.140 position:50% align:middle and we aren't losing anything related to validity and decision accuracy. 00:21:38.140 --> 00:21:43.376 position:50% align:middle So these are really good approaches, and I'll talk just a little bit more how we're going to do 00:21:43.376 --> 00:21:47.080 position:50% align:middle partial-credit scoring in this next slide. 00:21:47.080 --> 00:21:54.145 position:50% align:middle So there's different types of partial credit or polytomous scoring, and we're going to use all 00:21:54.145 --> 00:21:57.670 position:50% align:middle three of those because our items dictate that. 00:21:57.670 --> 00:21:59.690 position:50% align:middle So partial credit can be assigned three ways. 00:21:59.690 --> 00:22:05.063 position:50% align:middle You can have a candidate receive a point for a correct response and lose a point for an incorrect 00:22:05.063 --> 00:22:09.190 position:50% align:middle response, what we call this is plus-minus scoring. 00:22:09.190 --> 00:22:16.299 position:50% align:middle What this amounts to is allowing a candidate to over or under respond, meaning they can pick as 00:22:16.299 --> 00:22:22.270 position:50% align:middle many as they want or as less as they want, and we can still score that item, so we call it plus or minus. 00:22:22.270 --> 00:22:25.230 position:50% align:middle So if you look at this, which of these countries is in North America? 00:22:25.230 --> 00:22:28.480 position:50% align:middle And let's say the candidate picked France, Mexico, and Canada. 00:22:28.480 --> 00:22:34.990 position:50% align:middle Using plus-minus scoring, here's what happens, they get plus one for Mexico, 00:22:34.990 --> 00:22:41.340 position:50% align:middle they get plus one for Canada, and they get a minus one for France. 00:22:41.340 --> 00:22:48.510 position:50% align:middle When you add that all up, they get…there's a maximum of three points because it 00:22:48.510 --> 00:22:52.623 position:50% align:middle should have been Mexico, Canada, United States, they get a maximum three points, but they would 00:22:52.623 --> 00:22:56.510 position:50% align:middle get one point, two minus one, they got two right then minus one, 00:22:56.510 --> 00:22:59.370 position:50% align:middle they're going to get a one point. 00:22:59.370 --> 00:23:01.200 position:50% align:middle This has worked really well in our model. 00:23:01.200 --> 00:23:05.690 position:50% align:middle It's really stable for those items that allow for over and under responding. 00:23:05.690 --> 00:23:09.770 position:50% align:middle Now, you have another model that let's say you can't over-under. 00:23:09.770 --> 00:23:14.640 position:50% align:middle We tell you, you have to select a certain amount, and we won't let you select more than the amount. 00:23:14.640 --> 00:23:16.480 position:50% align:middle So that's sort of restricting this. 00:23:16.480 --> 00:23:18.440 position:50% align:middle We call it zero-plus scoring. 00:23:18.440 --> 00:23:24.300 position:50% align:middle So same example, instead of getting you a minus, you get either a zero or a plus one. 00:23:24.300 --> 00:23:30.650 position:50% align:middle So in this case, where we force them or restrict them from over responding or under responding, 00:23:30.650 --> 00:23:34.740 position:50% align:middle we use this model, so the candidate earns two points out of this. 00:23:34.740 --> 00:23:39.703 position:50% align:middle So there's still a maximum of three points, but there's no minus for France because they weren't 00:23:39.703 --> 00:23:42.200 position:50% align:middle free to pick more or less. 00:23:42.200 --> 00:23:43.760 position:50% align:middle They had to pick three. 00:23:43.760 --> 00:23:46.310 position:50% align:middle And this has worked out really well for us too. 00:23:46.310 --> 00:23:51.290 position:50% align:middle The third type is where we're using tokens and different things of that. 00:23:51.290 --> 00:23:55.740 position:50% align:middle The candidate then gets an all or nothing or a cloze. 00:23:55.740 --> 00:24:01.057 position:50% align:middle So think about that cloze item that I gave you where you had to pick the disease process and the 00:24:01.057 --> 00:24:03.890 position:50% align:middle evidence of that disease process. 00:24:03.890 --> 00:24:08.755 position:50% align:middle So I'm going to put this in not those terms but let's assume that you have to pick…you get these 00:24:08.755 --> 00:24:15.380 position:50% align:middle tokens, it's a cloze item, so the capital of, and you have to pick from that list, France is Paris, 00:24:15.380 --> 00:24:18.130 position:50% align:middle the capital of Egypt is Japan. 00:24:18.130 --> 00:24:23.261 position:50% align:middle We know that, that bottom one is incorrect, but the way this one gets scores is the, can only 00:24:23.261 --> 00:24:25.680 position:50% align:middle earn a single point for the pair. 00:24:25.680 --> 00:24:32.860 position:50% align:middle So if they get the capital right but the nationality wrong, they don't get any points. 00:24:32.860 --> 00:24:34.100 position:50% align:middle So it has to be connected. 00:24:34.100 --> 00:24:36.940 position:50% align:middle So you can't get one part of it right and one part of it wrong. 00:24:37.000 --> 00:24:38.260 position:50% align:middle Has to be connected. 00:24:38.260 --> 00:24:40.940 position:50% align:middle So per line, there is one point on this. 00:24:40.940 --> 00:24:42.800 position:50% align:middle So we're going to use that type of scoring model. 00:24:42.800 --> 00:24:46.700 position:50% align:middle Again, this has been really stable, as added credibility, 00:24:46.700 --> 00:24:56.170 position:50% align:middle and allowed us to have the appropriate reliability across scoring categories, very stable. 00:24:56.170 --> 00:25:03.000 position:50% align:middle The benefits of partial-credit scoring are numerous but importantly is partial-credit scoring has allowed 00:25:03.000 --> 00:25:04.610 position:50% align:middle for more precision of measurement. 00:25:04.610 --> 00:25:10.410 position:50% align:middle Remember that inter-rated reliability, inter-item correlation I'm talking about, 00:25:10.410 --> 00:25:16.941 position:50% align:middle this has allowed that because it's really tied to the complexity of items but having multiple ways of 00:25:16.941 --> 00:25:21.670 position:50% align:middle earning partial credit also reduces the impact of random guessing or gaming the items. 00:25:21.670 --> 00:25:25.380 position:50% align:middle So both of those have come about because partial-credit scoring. 00:25:25.380 --> 00:25:28.900 position:50% align:middle The other thing in partial-credit scoring obviously it has done is given us a great deal 00:25:28.900 --> 00:25:31.180 position:50% align:middle more item information. 00:25:31.180 --> 00:25:37.640 position:50% align:middle So for instance, partial-credit scoring in case studies have allowed us, per item, 00:25:37.640 --> 00:25:43.763 position:50% align:middle to gain probably three to four times more information per item than we have on the regular 00:25:43.763 --> 00:25:47.310 position:50% align:middle NCLEX, so another large benefit for us. 00:25:47.310 --> 00:25:52.724 position:50% align:middle We can make our decisions in a quicker way, get more information on the candidate in a much 00:25:52.724 --> 00:25:57.790 position:50% align:middle quicker way using partial-credit scoring. 00:25:57.790 --> 00:26:02.830 position:50% align:middle The other thing, though, to keep in mind, partial-credit scoring does not change our ability 00:26:02.830 --> 00:26:04.060 position:50% align:middle to use the CAT exam. 00:26:04.060 --> 00:26:05.740 position:50% align:middle We will continue to use that. 00:26:05.740 --> 00:26:08.840 position:50% align:middle It doesn't change our scaling. 00:26:08.840 --> 00:26:16.453 position:50% align:middle So the scores going forward with NGN will be comparable to the scores 2 years ago, 00:26:16.453 --> 00:26:17.596 position:50% align:middle 10 years ago. 00:26:17.596 --> 00:26:24.210 position:50% align:middle So we haven't broken that connection between following scores over time on the NCLEX. 00:26:24.210 --> 00:26:28.450 position:50% align:middle We've been able to do that for 20 years, and given what we've been able to do with partial credit, 00:26:28.450 --> 00:26:35.200 position:50% align:middle we will be able to do that long into the future, very positive thing for defensibility and credibility 00:26:35.200 --> 00:26:36.330 position:50% align:middle of the NCLEX exam. 00:26:36.330 --> 00:26:38.260 position:50% align:middle What is the test going to look like? 00:26:38.260 --> 00:26:41.150 position:50% align:middle Exactly what does it mean when I say test design? 00:26:41.150 --> 00:26:45.430 position:50% align:middle There's a lot of things that go into that, but I want to be clear what I'm talking about. 00:26:45.430 --> 00:26:47.120 position:50% align:middle How long is the exam? 00:26:47.120 --> 00:26:52.440 position:50% align:middle How long is the, you know, how long are the exam items, meaning not just in hours and minutes, but 00:26:52.440 --> 00:26:53.650 position:50% align:middle how many items are going to be on it? 00:26:53.650 --> 00:26:59.110 position:50% align:middle What's the mix of current knowledge items versus clinical-judgment items, and how will the items and 00:26:59.110 --> 00:27:01.250 position:50% align:middle cases be selected for delivery? 00:27:01.250 --> 00:27:03.360 position:50% align:middle How are we going to distribute them across the exam? 00:27:03.360 --> 00:27:05.200 position:50% align:middle That's an important piece as well. 00:27:05.200 --> 00:27:09.250 position:50% align:middle So I wanted to give you this information, where we're at. 00:27:09.250 --> 00:27:11.290 position:50% align:middle The length of the exam will vary by candidate. 00:27:11.290 --> 00:27:16.680 position:50% align:middle Remember, I told you that we were able to stay with the CAT, which means that we'll still have 00:27:16.680 --> 00:27:19.910 position:50% align:middle a variable-length CAT, nothing changes for the candidate in that regard. 00:27:19.910 --> 00:27:26.956 position:50% align:middle So the actual examination experience that has been the hallmark of NCLEX since it went to CAT 00:27:26.956 --> 00:27:29.280 position:50% align:middle will continue to be the same thing. 00:27:29.280 --> 00:27:31.630 position:50% align:middle What will we see that's a little bit different? 00:27:31.630 --> 00:27:35.480 position:50% align:middle So the minimum-length exam, the candidate with a very low or very high ability, 00:27:35.480 --> 00:27:41.380 position:50% align:middle remember, that's where the exam shuts off at the least amount of items. 00:27:41.380 --> 00:27:42.380 position:50% align:middle What will that entail? 00:27:42.380 --> 00:27:49.380 position:50% align:middle Well, that will entail in a minimum-length exam, the candidate will get three scored case studies. 00:27:49.380 --> 00:27:51.510 position:50% align:middle Remember, I already described the case studies. 00:27:51.510 --> 00:27:57.920 position:50% align:middle Those are going to be 6 items, thus, a total of 18 items that are tied together following a 00:27:57.920 --> 00:27:59.310 position:50% align:middle client care plan. 00:27:59.310 --> 00:28:03.410 position:50% align:middle The other one is that they will get 52 scored-knowledge items. 00:28:03.410 --> 00:28:06.110 position:50% align:middle So you can do some quick math here. 00:28:06.110 --> 00:28:15.750 position:50% align:middle That means the total minimum-length exam on the NGN will be 70 score items and 15 unscored item. 00:28:15.750 --> 00:28:20.070 position:50% align:middle Now, that's what we do today in the unscored items so that's no change. 00:28:20.070 --> 00:28:23.880 position:50% align:middle You'll see a little bit of a change in the scored items. 00:28:23.880 --> 00:28:29.580 position:50% align:middle We use 60 today, so there'll be 10 additional items when we add the NGN items. 00:28:29.580 --> 00:28:33.570 position:50% align:middle So the minimum number of items will go from 60 to 70. 00:28:33.570 --> 00:28:35.670 position:50% align:middle What is the maximum length? 00:28:35.670 --> 00:28:42.810 position:50% align:middle That means the total number in time that an individual can sit for the exam. 00:28:42.810 --> 00:28:47.915 position:50% align:middle And this always happens for individuals where their ability estimate, that we're measuring at this 00:28:47.915 --> 00:28:54.245 position:50% align:middle point in time, as they go through the exam is too close to their CAT score for us to have reliability 00:28:54.245 --> 00:28:57.710 position:50% align:middle meaning there's a little more error around it, and we need to give them more questions. 00:28:57.710 --> 00:28:59.260 position:50% align:middle So what are they going to get? 00:28:59.260 --> 00:29:04.430 position:50% align:middle Just like minimum length, they will get 3 scored case studies, another 18 items. 00:29:04.430 --> 00:29:12.850 position:50% align:middle So they won't get additional 18 item, they'll get the same 3 items in terms of distribution 00:29:12.850 --> 00:29:14.980 position:50% align:middle that the minimum links will get. 00:29:14.980 --> 00:29:17.990 position:50% align:middle They will get 117 other scored items. 00:29:17.990 --> 00:29:19.510 position:50% align:middle Here's where things change. 00:29:19.510 --> 00:29:22.670 position:50% align:middle So they'll get more other scored items. 00:29:22.670 --> 00:29:25.600 position:50% align:middle Most of those will be knowledge items. 00:29:25.600 --> 00:29:29.640 position:50% align:middle So remember, up top there was 52, now there's going to be 117. 00:29:29.640 --> 00:29:39.680 position:50% align:middle Most of that 117 will be knowledge items, but approximately 10% of those items will be the 00:29:39.680 --> 00:29:44.460 position:50% align:middle clinical-judgment, standalone items, that bow tie item that I was showing you earlier, 00:29:44.460 --> 00:29:46.680 position:50% align:middle and there'll be about 10% of those. 00:29:46.680 --> 00:29:48.330 position:50% align:middle So what does that mean in total? 00:29:48.330 --> 00:29:57.256 position:50% align:middle That the maximum-length exam will be 135 scored items and 15 unscored items for a total 00:29:57.256 --> 00:29:58.495 position:50% align:middle of 150 items. 00:29:58.495 --> 00:30:05.720 position:50% align:middle And that candidate will have five hours on a standard exam to complete the exam, 00:30:05.720 --> 00:30:10.630 position:50% align:middle more if that accommodations…if they need accommodations but the general is that. 00:30:10.630 --> 00:30:17.230 position:50% align:middle So I wanted to give this to you first, but I thought it'd be nice if I provided a comparative chart. 00:30:17.230 --> 00:30:18.590 position:50% align:middle So let's walk through this. 00:30:18.590 --> 00:30:21.890 position:50% align:middle The time allowed today for the NCLEX is five hours. 00:30:21.890 --> 00:30:30.850 position:50% align:middle The time allowed, minimum time and maximum time for the exam is five hours. 00:30:30.850 --> 00:30:33.260 position:50% align:middle So it's five hours, no matter what. 00:30:33.260 --> 00:30:36.210 position:50% align:middle Case studies, current NCLEX doesn't have any. 00:30:36.210 --> 00:30:41.983 position:50% align:middle The case studies in the minimum-length exam will be three, and then the maximum-length exam 00:30:41.983 --> 00:30:42.665 position:50% align:middle will be three. 00:30:42.665 --> 00:30:48.390 position:50% align:middle The clinical-judgment standalones, there are none today in the NCLEX, in the minimum exam, 00:30:48.390 --> 00:30:53.900 position:50% align:middle there will be none and in a maximum exam, there's going to be approximately seven. 00:30:53.900 --> 00:30:57.670 position:50% align:middle I said 10%, that's about where you would end up on that. 00:30:57.670 --> 00:31:03.578 position:50% align:middle So knowledge items, on the NCLEX today, there are 60 to 130, 00:31:03.578 --> 00:31:05.530 position:50% align:middle because that's all there are today. 00:31:05.530 --> 00:31:14.418 position:50% align:middle On the new exam, for a minimum-length exam, there would be 52 knowledge items and for a 00:31:14.418 --> 00:31:19.041 position:50% align:middle maximum-length exam, some are around 110. 00:31:19.041 --> 00:31:23.087 position:50% align:middle Because remember, about seven of those would be bow tie items. 00:31:23.087 --> 00:31:31.019 position:50% align:middle So total scored items today on the NCLEX is 60 to 130 on what it will be in the future is 70. 00:31:31.019 --> 00:31:32.480 position:50% align:middle You can see that on a minimum length. 00:31:32.480 --> 00:31:35.810 position:50% align:middle That's where the 6…so you compare 60 to 70, it will increase by 10. 00:31:35.810 --> 00:31:39.756 position:50% align:middle And the maximum length will increase from 130 to 135. 00:31:39.756 --> 00:31:44.930 position:50% align:middle Unscored items don't change and the CAT doesn't change either. 00:31:44.930 --> 00:31:49.349 position:50% align:middle So I did put some asterisks to say something about this and 00:31:49.349 --> 00:31:53.690 position:50% align:middle that is that items within case studies are static, they're not adaptive. 00:31:53.690 --> 00:31:57.660 position:50% align:middle So remember, there's always six items in a case study. 00:31:57.660 --> 00:32:03.560 position:50% align:middle And in that case study, those are static, meaning that you pick the case study and 00:32:03.560 --> 00:32:04.950 position:50% align:middle it doesn't change. 00:32:04.950 --> 00:32:09.600 position:50% align:middle The items within that case study don't adapt, they stay exactly the same. 00:32:09.600 --> 00:32:13.560 position:50% align:middle So I wanted to make sure I was clear on that, those are not adaptive, 00:32:13.560 --> 00:32:16.370 position:50% align:middle the case study is static once it is picked. 00:32:16.370 --> 00:32:19.750 position:50% align:middle So then what is beta testing look like and what does it mean? 00:32:19.750 --> 00:32:24.260 position:50% align:middle So I want to tell you, beta testing, I want to define what we define as beta testing here. 00:32:24.260 --> 00:32:30.871 position:50% align:middle And beta testing is what we call end-to-end testing of all elements of the NGN prior to launch. 00:32:30.871 --> 00:32:35.979 position:50% align:middle So lot of times when you do beta testing in psychometrics, you're just testing, do 00:32:35.979 --> 00:32:36.761 position:50% align:middle the items work. 00:32:36.761 --> 00:32:39.720 position:50% align:middle For us, beta testing is much bigger than that. 00:32:39.720 --> 00:32:45.380 position:50% align:middle So it's the registration and scheduling, it's the test publication, it's launching the exam, 00:32:45.380 --> 00:32:49.630 position:50% align:middle administering the exam, then it is actually looking at the function of the 00:32:49.630 --> 00:32:51.190 position:50% align:middle items and the cases. 00:32:51.190 --> 00:32:56.610 position:50% align:middle It's the algorithm, does it work, does the stopping rules work, the pass-fail decisions, 00:32:56.610 --> 00:33:02.400 position:50% align:middle and the data, and reports both internally for the council and externally for the regulators. 00:33:02.400 --> 00:33:06.310 position:50% align:middle That follows basically the alpha test. 00:33:06.310 --> 00:33:12.607 position:50% align:middle That means that we've built all of…most of this stuff that I just said, we've already built, but we're 00:33:12.607 --> 00:33:20.195 position:50% align:middle now alpha testing each of those as they are built and are completed to make sure that they 00:33:20.195 --> 00:33:23.240 position:50% align:middle individually work, and then we have to put them all together. 00:33:23.240 --> 00:33:28.090 position:50% align:middle So I want to talk about the beta testing, how we think that's going to work. 00:33:28.090 --> 00:33:32.800 position:50% align:middle We think that it should be two phases, and we're calling the first one "Friends and Family." 00:33:32.800 --> 00:33:43.053 position:50% align:middle We think that that one will start around April of 2022, and it will work in a way that is sort of high 00:33:43.053 --> 00:33:44.670 position:50% align:middle level in this regard. 00:33:44.670 --> 00:33:51.779 position:50% align:middle We, the NCSBN, are going to select the participants in this, and they will include regulatory board staff 00:33:51.779 --> 00:33:57.180 position:50% align:middle and some other stakeholders but no students are candidates. 00:33:57.180 --> 00:34:02.486 position:50% align:middle And we're going to administer this actually at the PPC similar to the way member 00:34:02.486 --> 00:34:04.046 position:50% align:middle board reviews occur. 00:34:04.046 --> 00:34:08.370 position:50% align:middle The point of this is that you, if you participate in this, 00:34:08.370 --> 00:34:11.250 position:50% align:middle would actually review a maximum-length exam. 00:34:11.250 --> 00:34:18.400 position:50% align:middle You'll get to see how those exams questions flow, how case studies flow, how the screens look, 00:34:18.400 --> 00:34:20.790 position:50% align:middle the test centers, how that operates. 00:34:20.790 --> 00:34:25.380 position:50% align:middle So it's basically friends and family, you're going to have an opportunity and probably a 00:34:25.380 --> 00:34:29.350 position:50% align:middle requirement to provide us responses to some set questions. 00:34:29.350 --> 00:34:35.570 position:50% align:middle We want to know about your experiences, you went through there to provide any concerns or 00:34:35.570 --> 00:34:37.590 position:50% align:middle enhancements that we might be able to make. 00:34:37.590 --> 00:34:40.560 position:50% align:middle That's what we're going to call "Friends and Family." 00:34:40.560 --> 00:34:42.870 position:50% align:middle Now, the other one I'm going to call "Live" beta test. 00:34:42.870 --> 00:34:48.817 position:50% align:middle Live beta test means exactly what it means and that is that we're going to actually test real 00:34:48.817 --> 00:34:54.341 position:50% align:middle nursing students who are expecting to graduate after April of 2023. 00:34:54.341 --> 00:35:00.050 position:50% align:middle We're going to start this in December of '22, and we're going to get these individuals to actually 00:35:00.050 --> 00:35:09.331 position:50% align:middle take a fully functioning exam that we will run all of the psychometrics on, all of the scoring algorithms, 00:35:09.331 --> 00:35:15.250 position:50% align:middle but we will not provide the scoring or the results, it will not count for this candidate, 00:35:15.250 --> 00:35:20.460 position:50% align:middle but they will be interacting with it in a real time real way. 00:35:20.460 --> 00:35:29.577 position:50% align:middle Reports will be generated for the NCSBN QC, but they will not be reported for licensure or other 00:35:29.577 --> 00:35:32.838 position:50% align:middle results outside of NCSBN. 00:35:32.838 --> 00:35:38.967 position:50% align:middle We think this is the best way to do this because you need real, live candidates to take it in such a 00:35:38.967 --> 00:35:46.065 position:50% align:middle way that you can determine that all things in a real situation are working well, but we also need those 00:35:46.065 --> 00:35:49.050 position:50% align:middle users of the results. 00:35:49.050 --> 00:35:50.500 position:50% align:middle So that's the friends and family. 00:35:50.500 --> 00:35:56.435 position:50% align:middle The regulatory bodies are the users of the results and we need them to take it and provide us with 00:35:56.435 --> 00:36:02.820 position:50% align:middle as much information as possible so that when we get results, they can not only trust those results, 00:36:02.820 --> 00:36:07.330 position:50% align:middle we can defend those results, but those results and how we report them are usable to those. 00:36:07.330 --> 00:36:11.830 position:50% align:middle So this is our approach to the…the two-phase approach to beta testing. 00:36:11.830 --> 00:36:16.000 position:50% align:middle And with that, I have actually come to the end of this. 00:36:16.000 --> 00:36:24.040 position:50% align:middle I will be hosting a question-answer session, if you will, at the midyear, 00:36:24.040 --> 00:36:29.975 position:50% align:middle at the upcoming midyear, and I wanted to actually give you an opportunity to see more in-depth 00:36:29.975 --> 00:36:37.740 position:50% align:middle information on this video presentation so that we can spend our time at midyear in a valuable way, 00:36:37.740 --> 00:36:41.920 position:50% align:middle you asking specific questions and me helping to provide specific answers. 00:36:41.920 --> 00:36:47.110 position:50% align:middle So I hope this has been helpful, and I look forward to seeing you at midyear. 00:36:47.110 --> 00:36:47.697 position:50% align:middle Thank you.