Credentialing and Licensing Excellence: NCSBN`s Journey

Credentialing and
Licensing Excellence:
NCSBN’s Journey
Dania Eter, MBA
Associate Director, Examinations
 NCSBN Mission – Protect the Public!
 Journey into credentialing and licensing
 NCLEX, NNAAP and MACE strengths
 Opportunities to further our mission
The Importance of Credentialing
 Nurses are the second largest group of
licensed professionals
 Over 2.5 million nurse aides are practicing
in nursing facilities
 700,000 nurse aide positions will need to be
filled in the next 25 years
 By 2030, 71.5 million will be at the age of 65
or older
 68% will probably be disabled
The Importance of Credentialing
Credentialing ensures that only safe
and competent nurses, nurse aides and
medication aides are allowed to
Protecting the Public
NCSBN Mission:
The National Council of State Boards of
Nursing (NCSBN) provides education,
service, and research through collaborative
leadership to promote evidence-based
regulatory excellence for patient safety and
public protection.
NCSBN Background
 Thirty-two year old, not-for-profit organization consisting
of 59 state and territorial boards of nursing
 Owner and developer of the U.S. nurse licensure
examinations (NCLEX-RN® and NCLEX-PN®)
 Owner and developer of the largest National Nurse Aide
Certification Examination (NNAAP®) and Medication
Aide Certification Examination (MACE®) in the U.S.
 Developing exams since 1978
 Administering NCLEX computer adaptive exams since
1994, to more than 3.4 million candidates
NCSBN Examinations Department
 19 NCSBN staff members assigned to
examinations program operations
 Combined experience of over 80 years in
nursing and testing
 Examinations Department:
 Provides psychometric, nursing and
administration expertise
 Conducts RN and LPN/VN practice analyses,
nurse aide and medication aide job analyses
 Develops NCLEX, nurse aide and medication
aide test plans
Assessment of Entry-Level Competency
 National Council Licensure Examination for
 National Council Licensure Examination for
 National Nurse Aide Assessment Program
 Medication Aide Certification Examination
Why is NCSBN a leader in the world of
 NCLEX Facts:
 NCLEX is the successor to the SBTPE, the national nurse
licensure examination used by various state boards of Nursing
for more than fifty years prior to 1982
 NCLEX has been administered via computer exclusively since
1994 when it was converted from Paper and Pencil to CBT
 Examinations administered continuously, on-demand in
approximately 240 NCSBN approved Pearson Professional
Centers around the world
 Both NCLEX-RN® and NCLEX–PN® are variable length,
computerized adaptive examinations
 Passing standard is evaluated every 3 years concurrent with any
test plan changes
Why is NCSBN a leader in the world of
 In 2008, NCSBN acquired exclusive ownership of the intellectual
property for two certification examinations
 NCSBN uses the following guidelines when developing the
NNAAP and MACE exams:
 Model Nurse Practice Act and Model Nursing Administrative Rules
 OBRA federal regulations for nurse aide programs
 Model curriculum for medication aide programs
 Examinations administered continuously in approximately 343
Pearson Regional Test Sites in the U.S. and offered in thousands
of in-facility sites to the nurse aides that train in them
 Passing standard is evaluated every 5 years concurrent with any
test plan changes
Candidate Volume
 Over 200,000 candidates sit for the NCLEX-RN®
examination each year, 75,000 sit for the NCLEXPN® examination
 Over three million examinations administered since
 32,074 examinations administered in international
test centers in 2010
 About 300,000 sit for the NNAAP exam each year
 Over 1,000 sit for the MACE each year
How is NCSBN able to protect the
Robust Examinations due to:
 Diligent test development processes
 Practice analyses/job analyses (research)
 Experienced Subject Matter Experts
 Strong psychometric expertise to insure legally
defensible exams
 Top test delivery services, Pearson VUE
 High security measures
 Prompt customer services
Exam Development Process
1. Practice Analysis
2. Test Plan
3. Item Writing and
Item Review
4. Subject Matter
Expert (SME)
Panel Review
5. Editorial Review
6. Building Test
7. Setting the
Passing Standard
8. Pretesting of Items
9. Administering
Board of
NNAAP ® and
MACE ® Exam
How the Process Works
Practice Analysis
 Conducted every three years for NCLEX and every five
years for NNAAP and MACE
 Ensures that the content of the exams reflects the practice
of entry-level nurses, nurse aides and medication aides
Test Plan
 The test plan provides guidelines for:
 Candidates preparing for the exam
 Direction for item development
 Facilitation for classification of exam items
How the Process Works – Continued
Exam Development Meetings
 Standard Setting
 SMEs determine the passing standard based on knowledge of
minimally competent professionals
 Item Writing
 SMEs write exam items based on their familiarity with entry-level
professionals and current practice
 Item Review
 SMEs working directly with the professionals who have entered
practice in the past 12 months review items for accuracy, currency
and one correct answer
 Sensitivity Panel (NCLEX)
 Experts review item wording to eliminate language that could be
considered elitist or stereotypical, words that have different
meanings to different ethnic or geographic groups, and/or words that
have an inappropriate tone
How the Process Works – Continued
 All newly written items are administered to at least 400 first-time, U.S.
educated test-takers in order to gather statistical information
DIF Panel
 Items that perform significantly different for a minority group are flagged
for Differential Item Functioning (DIF), which indicates potential item bias
Member Board Review
 Member boards are invited to review sample exams and pretest items
two times each year, and provide feedback (NCLEX only)
NCLEX Item Review Subcommittee
 The NCLEX Item Review Subcommittee (NIRSC) members consist of
board of nursing representatives and the group reviews all pretest and
master pool items
Master Pool Review
 Expert review items throughout the year in order to ensure that the exam
is current
Expert team of psychometricians ensure that
research is done on the following:
 Measurement construct – does the exam measure
entry-level knowledge?
 Ability – measured through practice analysis
 Content balancing – all areas of the test plan are
 Difficulty – ensure that item difficulty varies for
every exam taken
Psychometrics - Continued
 Testing models – is ability consistent with
 Differential item functioning – are all items
testing only nursing content?
 Readability analysis – are candidates
confused by item wording?
 Standard setting – does the passing
standard reflect the minimum amount of
ability that an entry-level candidate must
Administration (NCLEX)
 Approved Pearson Professional Centers 221 in the Americas, 19 internationally
 On demand delivery
 Exam security
 Ability to legally prosecute cheaters
 Biometric Collection
 ADA accommodations
 Stellar and prompt customer service
Administration (NNAAP/MACE)
 343 Pearson Regional Test Sites in the
U.S., rural and urban locations
 Thousands of in-facility locations
 On demand examinations
 ADA accommodations
 Stellar and prompt customer service
Work settings
 Long-term
care/nursing home
 Home health and
home care
 Hospital
 Continuing Care
Community (CCRC)
 Community Based
Residential Facility
 Long-term
care/nursing home
 Continuing Care
Community (CCRC)
 Community Based
Residential Facility
 Schools
Direct-Care Providers
 Make up one of the largest and fastest
growing workforces in the U.S.
 Projected need of 700,000 nurse aide
positions to be filled in the next 25 years
 Exposure – written forms (NNAAP)
 Confidentiality (Social Media)
 Endorsement - differences in rules for
applying to test and retest from state to
 Enhance security with computerized
NNAAP & MACE forms, robust item bank
 Facebook/Twitter, etc…
 Become the sole provider of NNAAP &
to continue to further our mission in
Protecting the Public!
 NCSBN will continue to ensures robust
examinations to protect the public
 NCSBN will continue to expand its nurse
aide and medication aide clients to ensure
consistency in practice and become the
voice for long-term care in order to continue
to further its mission in protecting the public
Examinations Social Media
 Have your students:
NNAAP & MACE Examinations on Facebook
NCLEX-RN & NCLEX-PN Examinations on
NCLEXInfo on Twitter
 Examinations information at their fingertips!
 Answers to their questions!
Thank you!

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