How UbiSim Prepares Nursing Students to Pass the Next Generation NCLEX

The Next Generation NCLEX for nursing students is coming up after the spring semester, are you ready to help your students prepare for the exam? 

Understanding the Next Generation NCLEX

The Next Generation NCLEX (NGN) is an updated version of the National Council Licensure Examination for Registered Nurses (NCLEX-RN) and Licensed Practical/Vocational Nurses (NCLEX-PN). It was aimed to ensure that newly licensed nurses are better prepared to handle the complexities of modern healthcare settings. 

Key features of the Next Generation NCLEX

1. New question types: It incorporates 7 types of questions that go beyond traditional multiple-choice questions
2. Focus on clinical judgment: The exam places greater emphasis on assessing a candidate's ability to make sound clinical decisions.
3. Case Study: Questions are often presented in the context of realistic patient scenarios.
4. Technology integration: The exam utilizes more advanced testing technology to create a more dynamic testing experience.
5. Alignment with current practice: The NGN is designed to better reflect the current healthcare environment and the skills needed by entry-level nurses.

What is Clinical Judgment?

Clinical judgment in nursing refers to the process of observing, interpreting, responding, and reflecting in clinical situations. It is an important skill that allows nurses to make decisions about patient care based on their knowledge, experience, and the specific context of each situation. The Next Generation NCLEX focuses on this skill because it is crucial for nursing students to obtain high-quality patient care and ensure patient safety. 

How Clinical Judgment is Measured?

The National Council of State Boards of Nursing (NCSBN) Clinical Judgment Measurement Model (NCJMM) is a framework designed to evaluate how well nursing students and new graduates can make sound clinical judgments in patient care situations. The NCJMM emphasizes the thought process behind clinical decisions rather than just memorizing knowledge. Which layer 3 exemplifies the 6 quantifiable cognitive skills that Next Generation NCLEX is evaluating for. 

The skills include: Recognize Cues, Analyze Cues, Prioritize Hypotheses, Generate Solutions, Take Actions, and Evaluate Outcomes.

The NCSBN Clinical Judgment Measurement Model. Retrieved from https://www.nclex.com/clinical-judgment-measurement-model.page 

How UbiSim Prepares Nursing Students to Study the Next Generation NCLEX?

UbiSim is a VR platform built just for nurses by nurse educators. The immersive  VR simulation scenarios are all designed based upon the test plan for Next Generation NCLEX. Our nurse educators align the needs assessment with the 6 quantifiable cognitive skills. This ensures that each nursing student has an opportunity to complete every stage of the clinical judgment process at their own pace, from recognizing cues to evaluating outcomes. Nurse educators can easily use our diverse catalog of pre-made scenarios, or use our web-based Editor to easily customize or develop their own VR scenarios focused on clinical judgment. UbiSim also offers a realistic context for learners to develop clinical judgment abilities. Realistic components like time limitations, risks, and repercussions all have an impact on the decision-making process.

Here are the Next Generation NCLEX Test Plan:

1. Safe and Effective Care Environment
   1. Management of Care
   2. Safety and Infection Control
2. Health Promotion and Maintenance
3. Psychosocial Integrity
4. Physiological Integrity
   1. Basic Care and Comfort
   2. Pharmacological and Parenteral Therapies
   3. Reduction of Risk Potential
   4. Physiological Adaptation

How UbiSim's VR Simulations Help Nursing Students to Practice Clinical Judgment?

Step 1: Recognize Cues

In UbiSim scenarios, nurse learners are tasked with identifying essential cues that dictate priority actions in clinical settings. The ability to distinguish between critical and non-critical cues is fundamental to effective patient management. Key cues that learners may encounter in UbiSim's scenarios include:

• Detailed electronic health records (EHR) outlining patient history, ongoing treatments including provider orders, medications, diagnostic images, and recent lab results.
• Real-time vital signs displayed on authentic medical monitors.
• Comprehensive assessment findings, both subjective and objective, that mimic real-life scenarios.

Engagement with these elements is designed to mirror actual clinical experiences, requiring learners to interact naturally with the environment and patient. This interaction builds their ability to spot and react to urgent healthcare needs such as fluctuations in vital signs or patient distress. 

https://youtu.be/BusdBXvMmRE

A nurse learner recognizes cues from the patient assessment – including cyanosis and abnormal lung sounds

Step 2: Analyze Cues

Once cues are recognized, the next step involves deep analysis to connect them to the patient's overall health status. Relevant cues that learners will need to evaluate in UbiSim scenarios include:

• Whether concerns raised by family members might indicate a decline in the patient's condition.
• The accuracy and current relevance of the EHR data
• Possible complications that could arise based on the patient's condition.

This analysis occurs with a realistic, immersive environment that simulates the pressures and demands of a real clinical setting.

Nurse learners analyze cues from a concerned parent

Step 3: Prioritize Hypotheses

Various symptoms, such as chest pain or difficulty breathing, could indicate severe conditions from myocardial infarction to asthma exacerbation. UbiSim challenges nursing students to prioritize the most likely and critical diagnoses first during their shaping of subsequent care plans. This real-time prioritization is crucial, especially as scenarios evolve with new information from lab results or changes in the patient's physical state. It prepares learners from both the Next Generation NCLEX and practical nursing roles.

Nurse learners prioritize hypotheses as they discuss the patient’s condition

Step 4: General Solutions

Solution generation in UbiSim scenarios is an important exercise in clinical judgment. Nursing students are encouraged to:

• Determine priority nursing interventions.
• Communicate effectively with health care providers to suggest further patient care actions.
• Identify and avoid potentially harmful interventions.

The freedom to explore various strategies within a safe and controlled environment allows learners to experiment and learn from each interaction. Thus, enhancing their problem-solving skills through these hands-on opportunities.

Nurse learners generate solutions by identifying actions that could achieve a desirable patient outcome

Step 5: Take Action

Action-taking in UbiSim scenarios involves critical decisions about immediate nursing interventions. Nursing students must decide:

• The order of medication administration.
• Prioritization of nursing tasks under pressure.
• When to escalate care by contacting healthcare providers.

This phase is crucial for transferring theoretical knowledge into practical skills. This includes reading the EHR, performing physical assessments, and providing therapeutic communication in the learner’s own words, all of these closely mirroring the real-life clinical setting.

https://youtu.be/-8rxChqZBnE

A nurse learner takes action when caring for a patient in respiratory distress

Step 6: Evaluate Outcomes

Learners need to assess the effectiveness of their actions by reassessing the patient, consulting with the team, and reviewing updated diagnostic information in UbiSim scenarios. This continuous evaluation is important in understanding the impact of nursing interventions and for planning further care if needed.

A nurse learner evaluates outcomes when reassessing the patient's vital signs

Developing Clinical Judgment Beyond the Scenario

Curated Debriefings

Following each simulation, UbiSim provides a comprehensive, situation-based experience that extends beyond the scenario itself. UbiSim provides detailed feedback through automated reports and a structured debriefing process based on the PEARLS framework. This report includes evidence-based, constructive feedback that aligns with the NCJMM. This reflection helps nursing students to understand their decision-making process and apply lessons learned to future clinical situations.

Unfolding Case Studies

After the simulation, nursing students will have unfolding case studies to engage with that provide additional context and follow-up scenarios to the initial simulation. These cases are designed to further refine clinical judgment skills through varied Next Generation NCLEX style questions, enhancing readiness for licensure examinations.

Final Thoughts

UbiSim's comprehensive VR simulations not only prepares learners for the Next Generation NCLEX but also equips them with the clinical judgment skills necessary for effective and efficient patient care. This integration of technology, simulation, and education makes UbiSim a pioneering tool in nursing education. 

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