Journal of Nursing Education

Letter to the Editor Free

NCSBN Clinical Judgment Measurement Model Clarification

Philip Dickison, PhD, RN; Katie A. Haerling, PhD, RN; Kathie Lasater, EdD, RN, ANEF, FAAN


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To The Editor:

Since the publication of the article titled “Integrating the National Council of State Boards of Nursing [NCSBN] Clinical Judgment Model [CJM] Into Nursing Educational Frameworks” (Dickison et al., 2019), published in the February 2019 issue of the Journal of Nursing Education, we have become aware of some misunderstandings about the Model that are causing concern. Despite best efforts to give accurate information and clarify the issue, the misunderstandings have persisted; therefore, the purpose of this letter is to provide clarification.

The Model is clearly described in the publication as an assessment model and has been presented in public meetings as the basis for constructing items about clinical judgment for the New Generation NCLEX (NGN). In the publication and even in its title, the point was to present the Model for testing and assessment purposes so that educators would know the Model represented and integrated the principles of the three predominant clinical judgment frameworks: intuitive-humanistic, dual process reasoning, and information processing.

For clarity, the name of the NCSBNCJM has been updated to the NCSBNCJMM, that is, the NCSBN's Clinical Judgment Measurement Model (NCSBN, 2019). It was never the intention that it should replace the three frameworks, which are theoretical and teaching models to help students learn to think like nurses. Rather, the NCSBN-CJMM is congruent with the three frameworks and serves as the platform for test-item construction about clinical judgment, something the NCSBN has validated has not been done well historically.

In summary, the NCSBN-CJMM was not designed to replace but rather encompass the three frameworks in common use to serve as a model for evaluation of students' clinical judgment on the NGN and to provide direction for educators to use it for their own assessments of students' clinical judgment. Do programs of nursing need to foster clinical judgment to prepare their graduates for practice? Of course, and in addition to the three frameworks, many specific strategies for doing so are available in the literature.

Philip Dickison, PhD, RN
Chief Officer, Operations and
Examinations, National Council of
State Boards of Nursing

Katie A. Haerling, PhD, RN
Associate Professor, Nursing
and Healthcare Leadership,
University of Washington Tacoma

Kathie Lasater, EdD, RN, ANEF, FAAN
Professor (Retired), Oregon Health and
Science University


  • Dickison, P., Haerling, K.A. & Lasater, K. (2019). Integrating the National Council of State Boards of Nursing Clinical Judgment Model into nursing educational frameworks. Journal of Nursing Education, 58(2), 72–78 doi:10.3928/01484834-20190122-03 [CrossRef]
  • National Council of State Boards of Nursing. (2019, Winter). Clinical judgment measurement model. Next Generation NCLEX News.

The authors have disclosed no potential conflicts of interest, financial or otherwise.


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