NEXT GENNEXT GEN - to Practice Nursing CLINICAL JUDGEMENT PROBLEM ...

2023-2024

CJMM Steps

NEXT GENNEXT GEN

STUDY GUIDE

STUDY GUIDE

NCLEX

CHANGES!

All you need to know about

NEXT GEN PRACTICE

EXAMS INSIDE!

ULTIMATEULTIMATE

NCLEXNCLEX

Case studies NGN Question Types LAB Values and many more!ReMarNurse.com

Are you ready for NCLEX Changes?Top 5 Skills Required to Practice Nursing 1

CLINICAL JUDGEMENT

2

PROBLEM SOLVING

3

CRITICAL - THINKING

4

ACTIVE LISTENING

5

PROFESSIONAL

COMMUNICATION

WHY IS THE

NCLEX CHANGING?

NGN was developed to strengthen the linkage between test items and clinical judgment using the Clinical Judgment Model.

PUBLIC SAFETY

of novice nurses had errors.of the errors were related to some poor judgement of either a task or an environment.of employers believed they received novice nurses who were effectively prepared to make clinical decisions.ReMarNurse.com 50% 65% 20%

The Clinical Judgment Measurement Model (CJMM) is what the new NCLEX is built on.Each layer represents the thought process needed to make a correct clinical judgment about a client who needs nursing care.Layer 0 represents the nurse determining the client's needs.Layer 1 represents the entire process of clinical judgment.According to the client response in layer 2, the nurse then moves through layers 3 and 4.Layer 3 is the area where testing can take place to determine the education of entry-level nurses and how they develop clinical judgment over a period of time. The six steps within layer 3 make up a repetitious process the student can improve over time with nursing experience and clinical exposure. This is considered the “action layer.” Layer 4 creates a realistic client scenario.The CJMM is appropriate for use in the lab setting, clinical setting, and on a standard written or computer examination.Layer 0 Hypotheses

THE NCSBN CLINICAL JUDGMENT

MEASUREMENT MODEL

Layer 1 Not satisfied Satisfied Layer 2 Layer 3 Layer 4 Client Needs Clinical Clinical Judgment Form Hypotheses Refine Hypotheses Evaluation Recognize Analyze Cues PrioritizeGenerate Solutions Take Actions Evaluate Outcomes Environmental Factor Examples Individual Factor Examples Environment Client Observation Resources Medical Records Consequences Time Pressure Task Complexity Cultural Consideration Nursing Process AssessmentAnalysisPlanningImplementationEvaluation ReMarNurse.com Cues & Risks Knowledge Skills Specialty Candidate Characteristics Prior Experience Level of Experience Decisions

STEP 1

RECOGNIZE CUES

(NCSBN CJMM Layer 3) (NCSBN CJMM Layer 4)

Environmental cues:

Location : Emergency

Department Parent present

Client observation cues:

Present age: 8-10 years

Present: sign/symptoms of

dehydration: dry mucous

membranes, cool extremities, capillary refill 3-4 seconds

Present/imply: lethargy

Medical record cues:

Present/imply: Hx of diabetes

Present/imply: Vital signs

Time pressure cues:

Set time pressure to vary with onset/acuity of symptoms Recognize signs/symptoms of dehydration Identify history of diabetes Recognize abnormal vital signs Hypothesize dehydration Hypothesize diabetes

STEP 2

ANALYZE CUES

Requires knowledge of pediatric development Requires knowledge of dehydration symptoms Requires knowledge of diabetes symptoms Describe relationship between level of blood sugar and dehydration Use evidence to determine client issues Cognitive OperationsFactor ConditioningExpected Behaviors / Actions The “Action Layer of Layer 3” has 6 steps that are important for nursing students to memorize and understand. Layer 3 is how Case Studies are written.Review the graph below. There are expected steps that a nursing student must take based on the information that is presented. Each case study will have 6 questions as a part of an unfolding case.ReMarNurse.com