Clinical Judgment Measurement Model
Overview
The CJMM is the foundation of Next Generation NCLEX (NGN) items. It describes 6 cognitive processes nurses use to make clinical decisions.
The 6 Stages
1. Recognize Cues
Identify relevant data from the clinical situation.
- What findings are significant?
- What is normal vs abnormal?
2. Analyze Cues
Organize and interpret the collected cues.
- What do these findings mean together?
- What patterns emerge?
3. Prioritize Hypotheses
Rank possible explanations by urgency and likelihood.
- Which condition is most likely?
- Which is most dangerous?
4. Generate Solutions
Identify expected outcomes and plan interventions.
- What are the goals?
- What actions should be taken?
5. Take Action
Implement the planned interventions.
- Which action is the priority?
- What is the correct sequence?
6. Evaluate Outcomes
Assess whether interventions were effective.
- Did the patient improve?
- Do we need to modify the plan?
Application in NCLEX
NGN Item Types
Next Generation NCLEX uses novel item types that test clinical judgment:
- Extended multiple response (select all)
- Highlight text
- Matrix/grid
- Drag and drop
- Drop-down/cloze
- Bow-tie
- Trend items