Clinical Judgment Measurement Model (NCJMM)

The NCSBN Clinical Judgment Measurement Model (NCJMM) is the intellectual framework underlying every NGN case study. Understanding this model is essential for success on the 2026 NCLEX-RN.

The Six Cognitive Steps

Every NGN case study walks through these six steps in order:

Step 1: Recognize Cues (Assessment)

What it tests: Can you identify relevant data from a patient's chart?

The nurse reviews history, labs, vital signs, and other data. The cognitive task is filtering "noise" from "signal"—distinguishing relevant findings from irrelevant information.

Example question: "Which findings require immediate follow-up?"

Step 2: Analyze Cues (Analysis)

What it tests: Can you link cues to clinical presentations?

The nurse interprets what the data means. For example, recognizing that tachycardia + hypotension + decreased urine output clusters together to suggest hypovolemia.

Example question: "The nurse recognizes these findings are consistent with which condition?"

Step 3: Prioritize Hypotheses (Analysis/Diagnosis)

What it tests: Can you evaluate likelihood and risk?

Among multiple potential problems (pain, anxiety, shock), which one poses the most immediate threat to life? This step tests prioritization skills.

Example question: "Which condition is the priority concern?"

Step 4: Generate Solutions (Planning)

What it tests: Can you identify expected outcomes and potential interventions?

Before acting, the nurse considers what tools and actions are available. This involves anticipating needs and planning care.

Example question: "Which interventions should the nurse plan to implement?"

Step 5: Take Action (Implementation)

What it tests: Can you perform interventions correctly and safely?

This focuses on the mechanics of specific nursing actions—proper technique, safety checks, and execution.

Example question: "Which action should the nurse take first?"

Step 6: Evaluate Outcomes (Evaluation)

What it tests: Can you determine if interventions were effective?

The nurse compares actual patient findings against expected outcomes to assess whether the care plan is working.

Example question: "Which finding indicates the intervention was effective?"

NCJMM and the Nursing Process

The NCJMM aligns closely with the traditional Nursing Process:

Applying the Model

When facing an NGN case study:

1. Read the scenario carefully—look for relevant cues
2. Ask yourself: "What do these findings suggest?"
3. Consider all possibilities, then prioritize by urgency
4. Think about what interventions address the priority
5. Consider how you would implement each intervention
6. Determine what outcomes would indicate success