Clinical Performance Exam Policy

PURPOSE
To outline the required components of the Clinical Performance Examination (CPX).

AUDIENCE
All medical students

LCME STANDARD
9.4 Assessment System        

POLICY

The Clinical Performance Exam (CPX) is a multi-stage objective structured clinical exam (OSCE) administered by UC Davis in collaboration with the California Consortium for the Assessment of Clinical Competence (CCACC) to all post-clerkship medical students. All graduating medical students are required to have completed the CPX and obtain a passing score for Overall Performance per Regulation 60.2 of the School of Medicine's Bylaws and Regulations.

        PROCEDURE

        The CPX is an 8-station OSCE that takes place during the months of May and June of each year. Rising post-clerkship students generally receive their assigned CPX test date by March. Students may swap time slots with their peers. 

        There are 3 possible scoring outcomes for the exam; Pass, Conditional Pass, and No Pass. 

        Pass 

        Passing scores are determined annually based on cohort performance and CCACC established metrics.  

        Conditional Pass 

        Any student who receives a Conditional Pass must work with a Clinical Guidance Lead (CGL) on clinical skills deficiencies. Initial meetings with a CGL are to be completed within 8 weeks of taking the CPX. The CGL will determine the specific activities of remediation and the plan must be approved by the CPX Director. After completing the plan, the student will receive a Pass on the CPX. The student will not be required to complete a CPX retake unless they have not completed their CPX remediation within 2 weeks of the CPX retake date. 

        No Pass 

        Any student who does not receive a Pass or Conditional Pass for their Overall Performance on their first attempt must participate in remediation directed by the CGL and obtain a passing score for Overall Performance on a CPX retake examination. Initial meetings with the CGL are to be completed within 8 weeks of taking the original CPX date. The CPX retake examination is a 6-station OSCE that occurs no later than 4 months before graduation to ensure graduation readiness. Failure to pass this retake will result in a referral to the Committee on Student Promotions. 

        Referrals 

        Students may be referred to a CGL based on low performance scores in an individual skill domain (e.g., History Taking, Physical Exam, Patient Education and Counseling, or Patient-Physician Interaction) or due to another identified deficit in clinical skills. In this situation, working with a CGL is highly recommended for ongoing development of graduation competencies, but is not required for passing the CPX. 

        Rescheduling

        Students needing to adjust their scheduled CPX date can exchange their time slot with another student; this must be completed at least 1 week before the scheduled CPX date. Each student must confirm the schedule change with the CPX Scheduling Coordinator and CPX Director by email within the stated time frame.

        If a student has an urgent or same day cancellation, they must notify the Associate Dean for Students, CPX Scheduling Coordinator, and CPX Director by email to ensure proper rescheduling. If there is no available make-up date within the UC Davis CPX cycle the student will need to take the examination at another CCACC member school.

        CPX Outside of UC Davis

        If a student has a rare instance in which they are not able to complete the CPX during the standard UC Davis CPX cycle, they must email the CPX Director and CPX Scheduling Coordinator for approval at least 1 month before the UC Davis CPX cycle. This request will be reviewed by the Associate Dean for Students, the CPX Scheduling Coordinator, and the CPX Director to allow for proper coordination of student testing if the request is approved. Such students must complete their CPX at one of the CCACC member schools during the standard CCACC member school CPX cycle (April-August). Students not completing the CPX by the end of August will be referred to the Committee on Student Promotions for failure to complete a graduation requirement.

        ACE-PC Program

        Students in the ACE-PC Program will follow an adapted timeline that fits with their academic calendar. 

        RESPONSIBILITY
        CPX Director

        REFERENCES
        School of Medicine Bylaws and Regulations, Regulation 60
        Satisfactory Academic Progress Policy
        Professionalism Policy

        POLICY OWNER
        Committee on Educational Policy

        REVIEWERS
        CPX Director
        Committee on Educational Policy*
        Committee on Student Promotions
        Curriculum Steering Subcommittee
        Executive Director of Clinical Skills Education

        REVIEW DATE and CYCLE
        February 2024, annual review cycle

        * Indicates the Policy Owner