By Debra Wood, RN, contributer
Arguably, the most important test of a nursing career, the NCLEX exam measures new graduates’ competencies and determines if they can practice as entry-level nurses.
Individual states license nurses provided they pass the NCLEX, developed by the National Council of State Boards of Nursing with assistance from registered nurses in clinical and academic positions.
“It was an honor to be selected to assist in NCLEX test development,” said Duane Anderson, RN, BSN, a charge nurse on the Child and Adolescent Psychiatric Service at the University of California, San Diego Medical Center.
Anderson wrote test questions for the practical nurse exam and participated in a Standard Setting Workshop, during which nurses collaboratively reach a consensus determining the degree of difficulty of a specific test item.
“It’s a great experience and great to meet nurses from around the country,” said Linda Gabriel-Marin, RN, MSN, with Gabriel Education Associates of Calistoga, Calif. Gabriel-Marin has volunteered twice to write NCLEX questions.
“It was fascinating,” Gabriel-Marin said. “I enjoyed the process. It was very stimulating.”
Nurses volunteer to write the questions or review items for accuracy, currency, job relatedness and appropriateness for an entry-level nurse. Questions are then tested before they become part of the NCLEX.
The NCLEX is a computerized adaptive test, meaning it adjusts the difficulty of questions presented to the test taker based on prior responses. With every additional answer, the estimate becomes more precise. The computer tailors each test to that examinee, selecting appropriate questions from an algorithm to ensure the queries are not too easy or too hard, forcing the test taker to guess.
The computer chooses questions from a large pool, excludes any items that the examinee has seen in the past year, balances the test so it has enough questions from each content area, and selects questions the examinee should find challenging.
The NCLEX test ends when time runs out at six hours or when the computer determines with 95 percent certainty the test taker’s ability is above or below the passing standard. For the registered nurse exam, that may require as few as 75 questions or as many as 265.
Prospective nurses pass if they answer the minimum number of questions and the computer detects he or she consistently answers above the standard on the last 60 items, according to NCSBN documents. Most examinees answer about half the questions correctly.
In 2008, 86.7 percent of registered nurses educated in the United States and taking the test for the first time passed it, compared with 45.3 percent of first time test takers from other countries.
NCSBN provides the volunteer nurses laptops to write the questions on, textbooks for reference, and continuing education credits. The work is confidential and cannot leave the room. It also pays for travel expenses, as all work takes place at the organization’s Chicago headquarters.
“The motivator is the involvement,” Anderson says. “I wanted to do something beyond my clinical work as a nurse and have an impact on my profession.”
Nurses interested in volunteering to write or review questions or set standards can contact the NCSBN through the organization’s Web site.
“There were important rewards for my participation in NCLEX test development,” Anderson said. “I received valuable training from NCSBN staff, and continuing education credit. I also got to meet terrific nurses from around the country and remain in contact with them.”
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