Summary of Proposed Changes 2013 NCLEX-RN® Test Plan Summary of Proposed Changes Janice I. Hooper, PhD, RN NCLEX Examination Committee, Chair Good afternoon welcome to the NCLEX Examination Forum. It has been my privilege to serve on the NCLEX Examination Committee for the past three years and as Chair for the past year and as a member. My impressions from my first NEC meeting, which have not changed, were that the process for the development and maintenance of the examination is awesome.

Outline FY12 NEC & NIRSC members, NCSBN Staff NCSBN Mission & NEC Charge FY12 Accomplishments Recommendation to the Delegate Assembly Rationale for the 2013 NCLEX-RN® Test Plan Recommendations Proposed 2013 NCLEX-RN® Test Plan Proposed Implementation Timeline Future Activities This presentation will provide information about the NCLEX examination committee’s work and accomplishments during the past year, as well as an overview of the NCLEX-RN Test Plan and the proposed changes to the Plan. The Report of the NCLEX Examination Committee begins on page 313 of the Business Book and provides the details for the information in this presentation. The Test Plan for 2013 begins on page 321 of the Business Book, with a copy of the new test plan and a strike-out version of the 2010 test plan. There will be time for questions at the end of the presentation.

FY 2012 NCLEX Examination Committee Janice I. Hooper, PhD, RN Texas Pamela Autrey, PhD, MSN, MBA, RN Alabama – Board Liaison Janine Baxter, MS, RN Idaho Usrah Claar-Peck, MS, MSN, RN Washington Tammy Claussen, MSN, RN, CNE Arkansas Roseann Colosimo, PhD, MSN, RB, CLNC Nevada Catherine Dearman, PhD, RN Alabama Patricia Kennedy, Ed.D, RN Maryland Francine Kirby , MSN, RN West Virginia Kathy Malloch, PhD, MBA, RN, FAAN Arizona Judith M. Pelletier , MSN, RN Massachusetts Lesleigh Robinson, MS, RN Ohio The NEC is one of the two standing NCSBN committees and the By Laws require that there are at least nine members, one representing LVN/LPN practice. I would like to acknowledge and thank the committee members who served during the last year and who represented areas across the country. A special thank you goes to Pamela Autrey, our Board Liaison, for her assistance. Would the committee members stand and be recognized.

FY 2012 NCLEX Item Review Subcommittee Pamela Ambush-Burris, MSN, RN, FRE Maryland William L. Anderson, JD, RN Kansas Susan C. Baltrus, MSN, RNBC, CNE Maine Kristin Benton, MSN, RN Texas Janice Britton, MEd, MSN, RN Louisiana-RN Debra Funk, RN Missouri Sara Griffith, MSN, RN North Carolina Deborah Haagenson, RN Minnesota Georgina R. Howard, MPA, RNBC New York Joy Ingwerson, MSN, RN Oregon Patricia Johnson, LPN Arizona Eileen Kugler, RN, MSN, MPH, FNP North Carolina Deborah Meyer, LPN Minnesota Cecilia Mukai, PhD, APRN, FNP-BC Hawaii Gene Pingle, RN, BSN-BC, CEN Washington Amy Price, MSN, RN Alabama It would be impossible for the NEC to fulfill its charges without the assistance of the NCLEX Item Review Subcommittee (NIRSC). NEC members act as Chair of the NIRSC meetings on a rotating basis. The subcommittee reviews all RN and PN examination questions, both pretest and operational items, as well as evaluates actual candidate examinations for face validity. Written reports from NIRSC are provided to the NEC for each business meeting.

FY 2012 NCLEX Item Review Subcommittee Continued Rebecca Reese, LPN Idaho Cristiana Rosa, APRN, PCNS Rhode Island Rhonda Taylor, MSN, RN Washington Linda Young, RN, MS, FRE, BC South Dakota If you are a member of the NIRSC, please stand so we may recognize your service.

NCSBN Examinations Staff Phil Dickison, PhD Chief Officer Dania Eter, MBA Associate Director, Business Operations Ada Woo, PhD Associate Director, Measurement & Testing Katherine Carlson, MSN, MHA, RN Content Associate Marijana Dragan, MS Statistician Melissa Franke Administration Manager Jennifer Gallagher Operations Manager Marie Garcia, M.Ed Project Manager Sarah Hagge, PhD Psychometrician Daniel Hydzik Operations Coordinator Chelsea Kelley Associate Lorraine Kenny, MS, RN Content Associate Bridget Martin Operations Coordinator Kathy Potvin Senior Operations Coordinator Logan West Senior Operations Coordinator Nicole Williams, MSN, RN-BC Content Manager I also wish to acknowledge NCLEX staff who provide valuable assistance to the committee. Please stand as I call your name. By doing this, you will identify yourselves in case anyone has questions for you. Phil Dickison, Chief Officer for Examination Dania Eter, Associate Director, Business Operations Chelsea Kelley, Associate – WILL NOT BE IN ATTENDANCE Nicole Williams, Content Manager Ada Woo, Associate Director, Measurement & Testing Other examination staff join the meeting as they are needed. The NEC meets for three regular meetings each year with a scheduled summer conference call, if needed. You can see that with the large committee and NCLEX staff involved, the meetings involve a large group. In addition, staff from Pearson VUE also attend.   I trust that my enthusiasm for this committee is evident. We began the year with an almost all new committee members. Staff conducted a comprehensive orientation that was so well-received that the committee requested ongoing educational sessions at each meeting. This has been very helpful in discussions and decision-making.

NCSBN Mission & the NCLEX Examination Committee Charge The National Council of State Boards of Nursing (NCSBN®) is responsible to its members for the preparation of a psychometrically sound and legally defensible examination. NEC Charge: To advise the Board of Directors on matters related to the NCLEX examination process, including examination item development, security, administration and quality assurance to ensure consistency with the Member Boards’ need for examinations, and To recommend test plans to the Delegate Assembly. The purpose for the NEC is twofold: To advise the Board of Directors on matters related to the NCLEX examination process, including examination item development, security, administration and quality assurance to ensure consistency with the Member Boards’ need for examinations, and To recommend test plans to the Delegate Assembly. The NEC has eight charges and one which is given high priority is: Participating in strategic discussions leading to enhancements of the NCLEX examination and its processes. We are well aware that the area of examination demands constant attention to precision as well as to the changing environment. The committee established the following criteria for managing and evaluating strategic discussions: Members agree upon a purpose for the discussion Members maintain the focus of the discussion The discussion stays within the time allowed Every member participates in the discussion and makes valuable contributions to the discussion Major issues and/or problems are identified and explored Members engage in active listening and refrain from interrupting each other An atmosphere of trust is prevalent

FY12 NEC Accomplishments Assessment of Member Board Review feedback Review BOD & Non-BOD NCLEX Policies & Procedures Approve PN activity statements, developed PN Practice Analysis Expert Panel & Reviewed PN Practice Analysis survey form Considered & took disposition on candidate appeals Approved sensitivity items, incident reports and DIF reports Approved the 2013 RN Test Plan for recommendation to the Delegate Assembly These criteria have provided guidance for a few successful strategic discussions. A few of the many accomplishments this year included: Reviewing member board feedback on examination items Reviewing Board of Director and non-Board of Director Policies and Procedures related to the NCLEX examination Approving PN Activity Statements as amended following development by the PN Practice Analysis Expert Panel Reviewing the PN Practice Analysis Survey Form Considering candidate appeals and taking disposition action Approving sensitivity items, incident reports, and DIF reports And one of the most important tasks for the year: Approving the 2013 RN Text Plan for recommendation to the Delegate Assembly

Recommendation to the Delegate Assembly Adopt the proposed 2013 NCLEX-RN Test Plan

Rationale for the 2013 NCLEX-RN® Test Plan Recommendations Recommendations are based on: 2011 RN Practice Analysis Expert Judgment Feedback from member boards The rationale for the proposed 2013 RN Test Plan is based upon the 2011 RN Practice Analysis, feedback from member boards, and the professional judgment and expertise of the NEC members. The triennial performance of the NCLEX® Practice Analysis provides a basis for subsequent review and revision of the NCLEX® Test Plan. The NCLEX practice Analysis is conducted every three years which consists of gathering data from entry-level nurses across the US. This body of work is a summary of activities rated as most important and/or performed most frequently related to supporting client safety and decreasing complications. Information gathered is directly used to make recommendations for the NCLEX Test Plan for concepts such as Activity Statements used to support item development activities. Client Needs Categories Percentages Used to determine the percentage of content distributed on the NCLEX exam. The test plan was approved by the BOD in December 2011. The draft was then submitted to member boards for review and feedback in December 2011. At the Midyear Meeting, information was presented and feedback was solicited. During the April 2012 NEC business meeting, the committee reviewed all feedback from member boards. The final RN NCLEX Test Plan was developed.

Proposed 2013 NCLEX-RN® Test Plan Overall format is retained Minor edits for currency and clarification Overall, the structure and format of the test plan remain the same. Minor editorial changes were made for currency and clarity. All sections of the test plan are retained

Proposed 2013 NCLEX-RN® Test Plan Content Area Client Test Plan Category 2010 Proposed 2013 1 Management of Care 16-22% 17-23% 2 Safety and Infection Control 8-14% 9-15% 3 Heath Promotion and Maintenance 6-12% 4 Psychosocial Integrity 5 Basic Care and Comfort 6 Pharmacological and Parenteral Therapies 13-19% 12-18% 7 Reduction of Risk Potential 10-16% 8 Physiological Adaptation 11-17% Categories have remained the same but some percentages have changed: Management of care went up one percentage point from previous Safety and infection control went up one percentage point Pharmacological and parenteral therapies went down one percentage point Reduction of Risk Potential went down one percentage point The changes in percentages were based on empirical data from the practice analysis study as well as psychometric considerations regarding the minimum number of test items necessary to reliably sample a content category.

Proposed Implementation Timeline 2013 NCLEX-RN® Test Plan August 2012: NCLEX Examination Committee present the Proposed 2013 NCLEX-RN Test Plan at the Annual Meeting for approval. September 2012: 2013 NCLEX-RN Test Plan is published on the NCSBN website. NCLEX Panel of Judges conducts the NCLEX-RN Standard Setting and makes passing standard recommendations to the Board of Directors. December 2012: Board of Directors evaluates and sets the 2013 NCLEX-RN Passing Standard. Timeline for implementation of the 2013 NCLEX-RN Test Plan – Follow Slide April 2013: Approved 2013 NCLEX-RN Test Plan and 2013 NCLEX-RN Passing Standard become effective.

Future Activities „„Complete the continuous online PN practice analysis. „„Continue to monitor all administrative, test development and psychometric aspects of the NCLEX examination program. „„Evaluate all aspects of the NCLEX program and initiate additional quality assurance processes as needed. „„Evaluate NCLEX informational initiatives, such as the NCLEX® Conference, NCLEX® Regional Workshops and other presentations. „„Evaluate ongoing international testing. „„Host the 2012 NCLEX® Conference. „„Introduce additional alternate format item types. „„Explore additional item writing strategies for the NCLEX. „„Conduct the PN practice analysis and KSA Study. Follow Slide.

Questions? The committee wishes to thank all member boards who reviewed the test plan and provided feed back Questions?