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How to do well on the CPX exam

Can you share with us how to do well on the CPX exam?  How did you prepare for the exam? What did you do well and what areas did you find you have to still work on? What comments did you receive from the standardized patients about your performance?

I’ve found some interesting articles that I’d like to share with you all. Any thoughts?

http://pritzker.uchicago.edu/md/curriculum/cpc/cpx/prepare.shtml

The video below is by the medical students at University of Maryland.

SOME ARTICLES

1: Am J Surg. 1995 Apr;169(4):418-20.

Checklist self-evaluation in a standardized patient exercise.

Kaiser S, Bauer JJ.

Department of Surgery, Mount Sinai School of Medicine, New York, New York 10029-6574.

BACKGROUND: Standardized patient (SP) exercises are expensive and time consuming. We hypothesized that self-evaluation would further the goals of teaching and evaluation for a group of medical students. METHODS: Students were given self-evaluation checklists (essentially identical to those filled out by the SPs) and completed them prior to reviewing the SP checklists. Agreement between student and SP checklists (whether each item was checked or not) and the extent of agreement on the interactional skills rating scales were assessed. RESULTS: Overall agreement was 93%, with 98% agreement on interactional items, 92% on physical examination items, and 89% on history items. Disagreements tended to be clustered on a few items in each scale. Scores on the interactional skills rating scales also showed strong agreement. CONCLUSION: The use of checklists and rating scales in this context is well established. At virtually no cost, a self-evaluation tool adds a valuable dimension to the exercise.

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1: Adv Health Sci Educ Theory Pract. 2004;9(3):179-87.

Communication skills in standardized-patient assessment of final-year medical students: a psychometric study.

David Geffen School of Medicine at University of California, Los Angeles, CA 90095-1722, USA. gguiton@mednet.ucla.edu

The purpose of this study is to investigate the content-specificity of communication skills. It investigates the reliability and dimensionality of standardized patient (SP) ratings of communication skills in an Objective Structured Clinical Examination (OSCE) for final year medical students. An OSCE consisting of seven standardized patient (SP) encounters was administered to final-year medical students at four medical schools that are members of the California Consortium for the Assessment of Clinical Competence (N = 567). For each case, SPs rated students’ communication skills on the same seven items. Internal consistency coefficients were calculated and a two-facet generalizability study was performed to investigate the reliability of the scores. An exploratory factor analysis was conducted to examine the dimensionality of the exam. Findings indicate that communication skills across the seven-case examination demonstrate a reliable generic component that supports relative decision making, but that a significant case-by-student interaction exists. The underlying structure further supports the case-specific nature of students’ ability to communicate with patients. From these findings, it is evident that individual’s communication skills vary systematically with specific cases. Implications include the need to consider the range of communication skill demands made across the OSCE to support generalization of findings, the need for instruction to provide feedback on communication skills in multiple contexts, and the need for research to further examine the student, patient, and presenting problem as sources of variation in communication skills.

PMID: 15316269 [PubMed – indexed for MEDLINE]

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1: Teach Learn Med. 2004 Winter;16(1):98-110.Click here to read Links

Taking standardized patient-based examinations to the next level.

Associate Dean for Curriculum Assessment, Duke University School of Medicine, Durham, North Carolina 27710, USA. petru001@mc.duke.edu

PURPOSE: The purpose of this article is to summarize this author’s view on “where we are” with standardized patient-based assessments of clinical performance and to offer three directions for further research and development. SUMMARY: The push for more objective outcome data has fueled proliferation of the most researched innovation in the history of medical education. Near-random clinical experiences of students do not provide consistent, repeated practice with important clinical cases to achieve minimally adequate performance on these objective performance examinations, leading to scoring “psychogymnastics” to titrate fail rates. The second area is to modify these examinations to reflect features at higher levels of professional development such as situational awareness. Theories of professional development should guide changes. The third area incorporates multiperson scenarios; a clinician with a family or a team in the operating room. Simulation of complex situations, especially those requiring rapid, accurate communication and action can reduce medical errors and improve patient safety. CONCLUSIONS: Standardized patient-based examinations provide objective outcome data but require artificial adjustments in scoring due to inconsistent learning opportunities. Theoretical research on professional development, acquisition of expertise and team functioning provides fertile, new directions to take standardized patient-based examinations to the next level.

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1: Acad Med. 1993 Aug;68(8):633-4.Links

Correlations between graduates’ performances as first-year residents and their performances as medical students.Smith SR.

Brown University School of Medicine, Providence, RI 02912.

PURPOSE: To correlate graduates’ performances as first-year residents with their performances as medical students, particularly their performances as seniors on a clinical skills examination using standardized patients. METHOD. Residency directors were asked to rate the first-year performances of the 232 graduates from the classes of 1989-1991 of the Brown University School of Medicine. Pearson correlation coefficients were calculated for the relationships between these ratings and the two scores (for data collection and interpersonal skills) that the graduates had received in their senior year on a clinical skills examination using standardized patients. Correlations were also calculated between the residency ratings and the graduates’ preclinical and clinical course grades and scores on Parts I and II of the National Board of Medical Examiners (NBME) examination. RESULTS. Ratings were returned and complete data were available for 203 (87.5%) of the graduates. Among all the parameters of medical school performance, the data-collection score on the clinical skills examination correlated best (.273) with performance as a first-year resident. The correlations between the residency ratings and scores on the NBME I and II were practically zero. CONCLUSION. This comparatively strong correlation between the graduates’ data-collection scores and their performance ratings as first-year residents suggests that performance-based assessments using standardized patients may be at least as good as–perhaps even better than–traditional methods of evaluating medical students in predicting their performances as first-year residents.

PMID: 8352876 [PubMed – indexed for MEDLINE]

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REVIEW BOOKS

BOARD EXAM REVIEW BOOKS
ABSITE KILLER Q&A .
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MCAT Q&A .
USMLE STEP 1 Q&A .
USMLE STEP 2 Q&A:
USMLE STEP 2 CS Q&A:
USMLE STEP 3 Q&A:

GENERAL SUBJECTS
Applied Physics in Medicine and Surgery:
Burn Management .

Commonly confused diagnoses and how to differentiate them :
Comparative Disease Statistics: (1)

Drug Mechanism of Action: Organized by Drug Name .
Drug Mechanism of Action: Organized by Mechanism .

Drug Side Effects: Organized by Drug Name:
Drug Side Effects: Organized by Side Effect:

Formulas, Equations, and Calculations: (2)
Head and Neck .

Most Commons in Medicine and Surgery.
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ATLS: Primary Survey.

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End Tidal CO2:
Epstein Barr Virus (EBV) (2)
Esophageal Leiomyomas: (2)
Estrogen :

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Familial Adenomatous Polyposis (FAP):
Family History :
Fluid resuscitation:
Fluids: (3)
Fluids and Electrolytes .
Fibromuscular dysplasia :
Fluid Resuscitation:
Focal Nodular Hyperplasia (FNH):

G
Gallbladder:
Gallstone Ileus:
Gastric Cancer (Gastric Adenocarcinoma) :
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Glucose

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Hepatitis: (2)
Hepatocellular Carcinoma: (2)
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Hernias:
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Inguinal Hernia Repair .
Intraoperative Complications:

K
Kaposi’s Sarcoma: (1)
Keloids and hypertrophic scars:

L
Laparoscopic Cholecystectomy :
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Liver .
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Liver Abscess: (2)
Liver failure:
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Lung Transplantation:
Lymphatic system and Lymph nodes :
Lymphedema :
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Lymphocytes : (3)
Lymphoma: (3)

M
Macrophages:
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N
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Numbers in Medicine and Surgery :
Nutrition and Metabolism .

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Oncogenes :
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Orthopedic Surgery .

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Parathyroid gland:
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Post Transplant Lymphoproliferative Disorder (PTLD): (2)
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Proton Pump Inhibitors (PPIs)
PTFE and Dacron Prosthetic Grafts :
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R
Radiation therapy :
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Renal failure
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Renal Transplantation:
Rhabdomyolysis and Myoglobinuria:

S
Short gut syndrome (Short bowel syndrome):
Small Intestines (Duodenum, Jejunum, Ileum)
Splenic Trauma, Splenic Injury, and Splenic Rupture .
Small Bowel Obstruction:
Sphincters:
Splenectomy:
Splenic Vein Thrombosis:
Statistics and Epidemiology in Medicine and Surgery.
Streptococcus:
Stomach.
Succinycholine:
Superior Vena Cava Syndrome (SVC Syndrome):
Surgical Infections .
Syncope:

T
T cells : (4)
Thoracic Outlet Syndrome (TOS) .
Thoracic Surgery .
Thoracotomy :
Thrombocytopenia:
Thromboelastogram (TEG) :
Thrombolytics and Thrombolysis:
Transplant Immunology:
Transplant Rejection:
Transplantation .

U
Unresectable Cancer:
Urology .
Ulcerative colitis:

V
Vagus Nerve:
Varicose veins:
VIPoma .
Vitamins :

W
Wound Healing .
Wuchereria bancrofti and Filariasis :

Z
Zenker’s diverticulum:

: means these topics are in the works
. means topics are almost completely finished and will be included in the next updated version of this ebook, which can be downloaded free

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SOURCE
Schwartz’s Principles of Surgery .
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The Practice ABSITE Question Book .
Surgery PreTest Self-Assessment and Review .
USMLE Step 2 Secrets
BRS Pathology
BRS Physiology
Pocket notebook EM
Hospitalist Handbook
SOAP Internal Medicine
First aid for the wards
CCS history and physical
Mont reid surgical handbook
Surgical recall
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