The Clinical Performance Examination (CPX) is a standardized patient-based clinical skills assessment; demonstration of at least minimum competency on this exam is a requirement for graduation. It is designed by a consortium of clinicians and medical educators from all nine California medical schools to assess clinical skills essential to the practice of medicine regardless of specialty.
The purposes of the exam are:
- To evaluate students’ level of competency in clinical and interpersonal skills;
- To provide individual feedback on these skills
- To prepare for the USMLE Step 2 Clinical Skills Examination (CS – the standardized patient portion of the boards).
The CPX 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 CPX is only administered at Stanford once per year, typically in July. Students planning away rotations should make sure their plans do not conflict with test administration dates, since failure to participate in and pass the CPX would prevent the student from graduating.
The exam involves a five-hour block of time. Each student’s exercise is videotaped and made available for review. Following the exam, students receive detailed feedback from the patient encounters and a set of scores with comparison standards.
During the CPX, 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 physical examination, and are also expected to communicate their thinking and preliminary plans to the patients. Students also complete eight inter-stations designed to assess clinical reasoning.
Students must demonstrate at least minimum competency in each of four skill areas:
- History taking
- Physical examination
- Communication skills
- Clinical reasoning
Students who do not attain an overall passing score on the exam, or who fail individual skill domains, will be required to successfully complete a remediation program, including individualized feedback, self-reflection, and working with a faculty mentor in the School of Medicine to develop the skills necessary for improvement. Following this remediation, students will undergo reassessment to ensure minimum proficiency with all categories of clinical skills. Successful completion of this reassessment exam will be required for graduation.
For more information, see the Standardized Patient Program website.
updated August 2017