PDF The Evolution of the NCLEX®: 20 Years as a Computer Adaptive Exam

Spring 2014

A PUBLICATION OF THE NATIONAL COUNCIL OF STATE BOARDS OF NURSING

The Evolution of the NCLEX?: 20 Years as a Computer Adaptive Exam

SEEING THINGS DIFFERENTLY | GLOBAL PERSPECTIVE | BRIDGING THE ONLINE DIVIDE

Spring 2014 | 1

Managing Editor and Writer

Jill Johnson | jjohnson@

Contributing Editor and Writer

Dawn Kappel | dkappel@

Designer

Kalona Rego | krego@

Stock photography purchased from .

Founded March 15, 1978, as an independent not-for-profit organization, NCSBN was created to lessen the burdens of state governments and bring together boards of nursing (BONs) to act and counsel together on matters of common interest. NCSBN's membership is comprised of the BONs in the 50 states, the District of Columbia, and four U.S. territories -- American Samoa, Guam, Northern Mariana Islands and the Virgin Islands. There are also 16 associate members that are either nursing regulatory bodies or empowered regulatory authorities from other countries or territories.

NCSBN Member Boards protect the public by ensuring that safe and competent nursing care is provided by licensed nurses. These BONs regulate more than 3 million licensed nurses, the second largest group of licensed professionals in the U.S.

Mission: NCSBN provides education, service and research through collaborative leadership to promote evidencebased regulatory excellence for patient safety and public protection.

The statements and opinions expressed are those of NCSBN and not the individual member state or territorial boards of nursing.

Copyright ?2014 National Council of State Boards of Nursing, Inc. (NCSBN) All rights reserved. This document may not be used, reproduced or disseminated to any third party without written permission from NCSBN.

Address inquiries in writing to NCSBN Permissions, 111 E. Wacker Drive, Suite 2900, Chicago, IL 60601-4277. 312.525.3600 | | infocus@

Spring 2014 | Volume 1 | Issue 2

In This Issue

3. Bridging the Online Divide

Catching Up with the Distance Learning Education Committee

4. Lead, Follow or Get Out of the Way

An Observation in Leadership By: Mark Majek, MA, PHR Director, Operations,Texas Board of Nursing

6. Seeing Things Differently

By: Ruby Jason, MSN, RN, NEA-BC, Executive Director, Oregon State Board of Nursing

Twila McInnis, MS, MPA, RN Director, Rhode Island Board of Nurse Registration and Nursing Education

10. Pencils Down, Booklets Closed

The Evolution of the NCLEX?: 20 Years as a Computer Adaptive Exam

17. Kentucky Board of Nursing Celebrates its Centennial

18. A Global Perspective: Nursing Regulation in British Columbia, Canada

By: Cynthia Johansen, MAL Registrar/CEO, College of Registered Nurses of British Columbia

21. Speed Round 21. Going Global 24. News & Notes

Learn. Grow. Connect.

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Bridging the Online Divide:

The Distance Learning Education Committee

All of NCSBN's committees tackle complex and sometimes difficult issues, but for the last two years the Distance Learning Education Committee (DLEC) has grappled with a particularly modern issue that didn't even exist before the advent of the Internet. It is the thorny problem of addressing nursing educators' perception that boards of nursing (BONs) are arbitrarily throwing up regulatory roadblocks and on the other side of the coin, addressing the challenges BONs face in ensuring the education that online students receive is on par with students in traditional classroom and clinical settings that the DLEC has been tasked with since its formation in 2012.

Today, an unprecedented 6.7 million students are taking at least one online course; 32 percent of all students in higher education are taking at least one online course and nursing students are no exception to using this technology to receive college credit (Allen & Seaman, 2013).

It is these issues coupled with the exponential growth in the number of nursing students using distance education that the committee, composed of a diverse group of nursing professionals, has tackled with good humor, mutual respect, a deep dive into available research and futuristic solutions to existing obstacles. The committee members, most of whom are new to serving on an NCSBN committee, are not new to sharing their expertise and providing expert guidance on issues regarding nursing and nursing education. Reflecting on his tenure as DLEC Chair, Bobby Lowery, PhD, RN, FNP-BC, FAANP, assistant professor, East Carolina University, College of Nursing, and board member, North Carolina Board of Nursing, observed, "We came together as leaders in our respective areas and brought a wide range of thoughts and ideas to the table. Our differing opinions on the issues involved could have pulled us apart but instead the overarching goal of trying to find the best way to ensure public protection pulled us together and made us stronger."

Charged at its inception by the NCSBN Board of Directors to identify regulatory issues regarding distance education and to propose model education rules, the DLEC finished its initial charges in 2013, but based on outstanding issues identified by BONs,it asked for a second year to continue to refine and expand upon its already completed foundational work. Throughout the 2013-14 fiscal year, the committee wrote a white paper, Nursing Regulation Recommendations for Distance Education in Prelicensure Nursing Programs, presenting the regulatory perspective of prelicensure distance education programs from a variety of viewpoints. The committee also developed prelicensure regulatory guidelines, and proposed model education rule and act revisions. "As the board liaison, I was very impressed with how serious and dedicated this committee was to its charges and goals," remarked NCSBN BOD Director-at-Large Betsy Houchen, JD, MS, RN, executive director, Ohio Board of Nursing.

Trying to find solutions that would work for all jurisdictions found committee members having to put aside notions of "we do it this way in my state" in order to find solutions that would best fit the demands of nursing distance learning education in the 21st century and into the future. "I am proud of the fact that we were able to work cooperatively through occasional frustrations to come up with innovative

continued on page 23

Today, an unprecedented 6.7 million students are taking at least one online course...

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Pathways to Leadership

"Lead, Follow or Get Out of the

Way"

By: Mark Majek, MA, PHR Director, Operations Texas Board of Nursing

An Observation of Leadership

There is ongoing debate as to the author of this quote that titles this article, but to this day, it is one of the most used phrases in leadership. Some believe that this phrase is terse, rude or even overly blunt and should be relegated to a bumper sticker or quietly whispered among those in "the know."

From my perspective, it is a distinct leadership style used by astute leaders who recognize that traditional management styles no longer meet our regulatory needs, with tight budgets and changing generational expectations. While we cling to old style management, younger workers are demanding a different approach. What will be our succession plan for the future?

I have been fortunate to observe many different leadership styles in the past 26 years as a staff member with the Texas Board of Nursing, working with NCSBN and currently serving on the NCSBN Leadership Succession Committee (LSC). In these groups, three common leadership themes emerged: knowing when to step forward, knowing when to defer to an expert and knowing when to get out of the way of someone who has a better idea. I am not suggesting abdicating leadership, but instead, sharing it with those around you who can offer a different perspective, who can be constructive with their actions and who can follow up with their original ideas. As leaders, we are tasked with accountability whether we lead, follow or get out of the way. All three are vital and important.

Lead The most effective leaders I've observed have led with confidence and humility. When faced with a new committee leader, executive officer or board president, I quickly pick up on their leadership style and adapt to that perception.The most effective leaders adapt their leadership style to the group which fosters trust and open communication within the team.They are firm in their convictions, but also honest with themselves and can admit that they do not have all the answers.

Follow When you have a team of high performers without direction, chaos can ensue.The most effective leaders I observed could facilitate the topic, back off and listen, then allow the group to come to consensus on its own. Members of a group can be leaders in their own right, contributing from their fields of expertise and bring that knowledge to the table. In the end, after following through on the ideas of others, the effective leader helps synthesize the thoughts, seeks clarification and then retakes the lead.

4 | In Focus

Get Out of the Way This is the most difficult concept for most leaders to incorporate. Some view this tactic as the absence of leadership. I, however, see this as allowing your group to totally engage in the process and move through the "forming, storming, norming and performing" model, as created by psychologist Bruce Tuckman. If members of a group openly engage in a process, it allows the organization to identify both informal and formal leaders, and thus begin to embark on succession planning.

What might seem to be obvious sometimes escapes us as leaders while we try to anticipate our challenges. As a staff member at a board of nursing and a member of the LSC, I have had the opportunity to observe great leaders facing difficult situations and, unfortunately, see other leaders struggle in similar situations. In my observation, the leadership qualities cited above can be highly successful when fully implemented and used. It is up to us to decide if we want to lead, follow or get out of the way and move our organization forward and allow future leaders to emerge.

There are many leadership paths and opportunities for members of NCSBN to support professional development. Learn more through the NCSBN Leadership Development Program ( username and password required).

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a recap of the 2014 ncsbn

midyear meeting, as told by two new

e x e c u t i v e o f f i c e r s w h o at t e n d e d t h e m e e t i n g fo r

the first time.

6 | In Focus

In March, the 2014 NCSBN Midyear Meeting took members to Kansas City, Mo. to network, receive updates on NCSBN committee work and discuss issues affecting nursing regulation, specifically focused on the future of nursing and telemedicine.To get a better idea of what goes on at this meeting, we invited two executive officers new to their role to tell us about their first Midyear Meeting experience, including who they met, what they learned and why attending this meeting is so important to their job.

Ruby Jason, MSN, RN, NEA-BC Executive Director, Oregon State Board of Nursing

After a 30-year career in acute care, 25 years as a manager/director, I have entered the world of board of nursing regulatory enforcement. A world with new vocabulary (how many acronyms can you squeeze into a process?), strange and different hours of operation (what? No one is here at night and on weekends? We closed for a snow day?) and having to read all of the Oregon Nurse Practice Act that I used to be able to skip (administrative chapter? Fee schedule?). Having been an expert in my area of practice (administration), I now felt like a novice and, at my age, being a novice is an unfamiliar place.

In the office of my predecessor I found much material that seemed to come from an organization called NCSBN. Since the acronym was unknown to me (and there certainly seemed lots of materials, files, books and fliers with this unknown alphabet jumble), I decided that this information was probably something I needed to know about...soon, after I attended to other "more important" information that I needed to learn about this brave new world I had entered.

Day one on the job, I was informed that not only that I was expected to attend an NCSBN meeting

in Kansas City, but that my chief financial officer had resigned. Day three on the job, the licensing manager also resigned and on day four the chief investigator resigned too (with everyone's assurance that it "was not about you"). In my previous life I could step into a manager role and hold everything together until a new manager was hired...what was I to do here? I couldn't even figure out the acronyms, let alone what I was actually supposed to be doing and what the work of the agency truly had to be, and I certainly could not be expected to attend a meeting 30 days into the job!

Off to Kansas City I went and thanks to the great staff here at the Oregon Board of Nursing, I felt I was gaining some momentum. I was very concerned that attending a meeting was going to break my stride and be something that would be a hindrance rather than substantive (after all, I had been attending meetings for 30 years...what more could yet another meeting teach me?).

Well, I am happy to report that I was wrong, wrong, wrong!

It takes a village to raise a child...it takes NCSBN to calm down a new executive officer.

Finally...context! Connections! Resources!

The first day of meeting was a leadership day for executive officers.The information regarding "Governance as Leadership" gave me a different view of leadership that I had not appreciated prior. The area meeting allowed me to connect with the collective consciousness of other executive officers, their ideas, their issues and their solutions.The group was welcoming and quickly inclusive. Offers of "call me if you ever need anything" was the mantra of the day and gave me a sense of community that I really needed (and that I had missed; all my other contacts are hospital administrators).

As I moved through the sessions I realized that I was now on the other side of many issues.The increasing issue of telehealth and the effect on licensure is a side of the telehealth conversation I had not previously attended to.The same was true for legislative updates, APRN consensus and the APRN compact -- an issue that very much affected my previous practice as the

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