University of Virginia School of Medicine Curriculum Committee Minutes 10.23.03
Surgery Conference Room,
Present (underlined) were: Reid Adams, Eve Bargmann, Robert Bloodgood,Anita Clayton,Gene Corbett, Carl Creutz,Donald Innes (Chair),Vern Juel, Howard Kutchai, Chris Peterson, Jerry Short, Linda Watson,Bill Wilson, Brian Wispelwey, Maria Meussling, David Shonka,Ryan Zaklin,Debra Reed (secretary), Guest: Anne Chapin
CPX Program.(Anne Chapin, Director)Ms. Chapin provided the Curriculum Committee with an overview of the CPX program.She began by showing a video of a typical patient interview session from the CPX examination.The examination takes place after the third year, is developed around seven standardized patients and takes 4hours.Grades are determined by faculty/resident observation of the interview/examination, assessment of the clinical reasoning exercise, and evaluation of an oral presentation of one of the simulated cases.The seven cases are developed by the Clerkship Directors and reviewed by the CPX Committee.
Students must score in the 16th percentile relative to the other students in four or more cases to pass this examination.Ninety-seven percent of students passed the exam this year.Over the past five years, examination means have remained relatively consistent. Remediation is available for those who do not pass the examination.At present there is no re-test procedure for failures but this is an option that will be explored.Insufficiencies noted on the exam include performance of physical examination skills incorrectly or not at all; problems with clinical courtesy, e.g. introductions or hand washing.Some physical examination “bad habits” believed to be learned during the clerkships will be addressed with the Clerkship Committee.Attention to detail by the student in the CPX testing is essential and will probably be just as essential in the USMLE Step 2CS examination.
Students with low performance scores often comment on the mystery and surprise of exam – lack of preparation, the difficulties of the time constraints; and being unprepared for a role as a first year resident when medical students in clerkships have far less responsibilities. Clerkships need to better prepare students for this role.
Are our students ready to pass USMLE Step 2CS?The CPX Program as it is now is comparable to the USMLE standardized test and should help prepare our students.Standardized patient exercises might be introduced within the third year for additional formative feedback and as further preparation for the UXMLE Step 2CS.The Curriculum Committee will want to see comparative data when available on the CPX and USMLE Step 2CS examinations.A modified or on-going study session might need to be developed for students prior to taking the USMLE Step 2CS.