2855 Arbutus Street Vancouver, BC V6J 3Y8 Canada T: 604.736.7331 F: 604.738.2272 Toll-free: 1.800.565.6505 Registered Nurse Application Form NCLEX–RN Standard Setting Panel of Judges The National Council of State Boards of Nursing (NCSBN) is recruiting registered nurses to sit on the Standard Setting Panel ofJudges. The panel will meet in Chicago, Sept. 9–11, 2015. Please complete both pages of the form. The application deadline is May 12, 2015. Return your completed form to kivari@crnbc.ca or fax 604.738.2272. A B O U T T H E N C L E X – R N STA N DA R D S E TT I N G PA N E L The NCLEX-RN® Test Plan is evaluated on a three-year schedule involving an extensive job analysis survey of newly licensed nurses and input from various nursing experts. The latest NCLEX-RN® Test Plan becomes effective April 1, 2016. Along with the test plan, the passing standard is re-evaluated on a three-year cycle to ensure the appropriate passing standard is in place for the corresponding examination. NCSBN’s Board of Directors is responsible for setting the passing standard but the tasks performed during the panel of judges meeting will help the Board of Directors when the standard setting decision is made. The Standard Setting Panel of Judges will comprise a minimum of nine (9) members, representing various NCSBN regulatory bodies using NCLEX for primary licensure purposes. The group will reflect registered nurses with varying years of nursing experience in entry-level clinical practice areas. Travel-related expenses will be covered by NCSBN. A P P L I C AT I O N First name Last name Address Registration ID Email TelephoneCell Employer Job title Do you work with, supervise, and/or educate newly registered RNs within their first 12 months of practice? Yes No Do you work in clinical practice? Have you been employed as an RN for at least two or more years? Have you been employed less than one year as an RN? Yes No Yes Yes No No next page . . . 1/2 Please describe why you are a good candidate for the NCLEX-RN Standard Setting Panel of Judges. What special skills and knowledge will you bring to the meeting? 2/2
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