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Information for Students

Welcome!  The Stanford Standardized Patient Program develops and administers clinical encounter-based exams throughout the medical school curriculum.   We currently offer exams for both preclinical students (primarily during the two-year Practice of Medicine course) as well as for clinical students during core clerkship rotations and for the statewide Clinical Performance Examination (CPX), held early in the summer.  Passing the CPX is a requirement for graduation.

Clinical Performance Examination (CPX)

The CPX is a standardized patient exam that is a graduation requirement for all Stanford medical students. It may be taken at the end of the first year of clerkships, but must be taken no later than one year prior to graduation.

The four purposes of this exam are:

  1. To evaluate your current level of competency in clinical and interpersonal skills;
  2. To provide individual feedback on these skills in preparation for your residency training;
  3. To prepare you for the USMLE Step 2 Clinical Skills Examination (standardized patient portion of the boards);
  4. To evaluate the effectiveness of our overall curriculum.

laughing MD students in Modular EThe CPX is designed by a consortium of clinicians and medical educators from all eight California medical schools to assess clinical skills essential to the practice of medicine regardless of specialty. Over 1000 students take this exam each year. During the exam, students see eight patients with a broad range of problems, which may encompass subject material from any core clerkship. Students are expected to perform a focused history and usually a physical examination as well.  Students are expected to communicate their thinking and preliminary plans to the patients.

All students must pass the CPX in order to graduate. Students planning away rotations should make sure their plans do not conflict with test administration dates (see below), since failure to participate in and pass the CPX would prevent the student from graduating.

For those students who do not demonstrate a minimum standard of competency, we will formulate a specific remediation plan.  Such students will work with a faculty preceptor or advisor to identify strengths and weaknesses and make plans for improvement.  There will also be a re-assessment exam scheduled for the last Monday in period 7 (1/25/2010) and the second Monday in period 8 (2/8/2010).  Please take this into consideration when planning potential away clerkships, as you must be on-campus for this re-assessment in the event that you do not pass the CPX.

Mini-CPX and Micro-CPX

The Mini-CPX, a four-station examination, is offered in March of the second year of the medical school curriculum.  This examination is similar in format to the CPX and serves both as a “final exam” for the preclinical clinical skills curriculum and as a means for students to identify skill areas on which to focus prior to entering clinical clerkships.  Students who do not attain an overall passing score on the exam will be identified for remediation.

Q3 students before going to Modular E


The Micro-CPX is a two-station examination offered in June of the first year of the medical school curriculum.  Like the Mini-CPX, the Micro-CPX is similar in format to the CPX and is a good means to assess your skills at the conclusion of your first year of medical training.

Both the Mini-CPX and Micro-CPX are administered as part of the Practice of Medicine Course at Stanford.



Frequently Asked Questions About the CPX

When is the CPX administered at Stanford?

Period 1, July 13-24, 2009 from 1- 6:30 PM

How do I sign up for the CPX?

You can sign up for the Clinical Performance Examination by going to http://reggie.stanford.edu/Signup.asp?2067 The deadline for registration this year is Fri, Jan 16, 2009.

How do I prepare for the CPX?

You do not need to study any specific material for the CPX.  However, you can prepare for the examination by:

  1. Knowing differential diagnoses for common clinical problems and clinical scenarios;
  2. Reflecting on how these differential diagnoses may affect the approach you will take in your focused history and physical;
  3. Reviewing your physical examination skills and the appropriate techniques by which to perform them;
  4. Observing basic fundamentals of physical examination behavior, such as proper introductions, hand washing, and measures to keep the patient’s comfort and perspective in mind.

What do I need to bring to the CPX?

Your attire should be professional and all you need to bring is: (1) a white coat; (2) a stethoscope; and (3) yourself.  All other medical supplies will be provided in the examination rooms.  For most SP exercises, all other materials you may need (ophthalmoscope, tuning fork, other medical equipment) are provided for you. You will be provided with a clipboard and scratch paper for your own note-taking. You will not be permitted to bring pocket guides or other “cheat sheets” into the exam.

What happens if I do not pass the CPX?

Successful completion of the CPX is a requirement for graduation. Students who do not will be required to successfully complete a remediation clinical skills examination, offered in the last Monday in period 7 (1/25/2010) and the second Monday in period 8 (2/8/2010).  In the event that you need to take this exam, the faculty in the School of Medicine will help you develop the skills necessary for improvement.

What if I can’t make any of the CPX dates?

You must notify Julianne Arnall, Standardized Patient Program Manager, at julianne@stanford.edu as soon as possible. She will work with you to find a solution. Please types "urgent CPX scheduling conflict" in the subject line.

Quarter 3 students in Modular E hallway reading presenting informationCan I switch the date of my CPX?

You cannot change the date of your examination once you have signed up for the CPX.  However, you may trade time slots with another student.  It is up to you to make any necessary arrangements.  Both students must email Sara Capule, Standardized Patient Program Coordinator, at scapule@stanford.edu acknowledging that they consent to the trade.

Where are SP exercises held?

Until we move to the new Learning and Knowledge Center, all SP exercises, including the CPX, are located at 1215 Welch Road in Modular E on the Stanford University School of Medicine campus.

How am I being evaluated?

Generally, students are evaluated in several skill areas.  These include, but are not limited to, history taking, physical examination skills (not just whether you perform a certain maneuver but also if it is done correctly), the ability to communicate information to patients, and interpersonal skills.  Sometimes there are additional inter-station exercises, following the patient encounter, that assess knowledge and clinical reasoning.  Students are evaluated by both the standardized patients and faculty observers.

Will I get feedback on my SP exercise?

Yes.  For the clinical performance examinations in general, after the entire class has completed a given exam, you will receive detailed feedback from the patient encounters and a set of scores with comparison standards.  For many of the preclinical and clerkship exercises, rather than receiving written feedback, you will receive individualized one-on-one feedback from the standardized patient and/or a faculty observer.

These are just actors, right?

Not necessarily.  For some exercises, we hire professional actors for cases that involve simulations of exam findings or emotionally charged scenarios.  Sometimes, however, we use real patients with real histories and physical exam findings.  Remember that all standardized patients are people – and you should treat them as your patients, not as actors.

Links for students

History and Physical Examination Skills

USMLE Step 2 Clinical Skills Exam

Articles about SPs

 

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