Clinical Performance Exam Policy

PURPOSE
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 medical students. This policy outlines the CPX requirements and completion procedure.

AUDIENCE
All medical students, faculty, and staff

LCME STANDARD
9.4 Assessment System        

POLICY

  1. All graduating medical students are required to complete the CPX and obtain a passing score for Overall Performance per Regulation 60.2 of the school of Medicine's Bylaws and Regulations.
  2. Students are eligible and required to take the CPX after they have completed at least 5 of their 6 required core clerkships.
    • Enrolled students who meet this requirement are not permitted to delay the CPX to a subsequent administration.
  3. There are three possible scoring outcomes for the exam: Pass, Conditional Pass, and No Pass.
    1. Pass: Passing scores are determined annually based on cohort performance and CCACC established metrics. 
    2. Conditional Pass: Any student who receives a Conditional Pass must work with a Clinical Guidance Lead (CGL) on clinical skills deficiencies.
      1. Initial meetings with a CGL are to be completed within 8 weeks of taking the CPX.
      2. The CGL will determine the specific activities of remediation and the plan must be approved by the CPX Director.
      3. After completing the plan, the student will receive a Pass on the CPX.
      4. 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.
    3. 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.
      1. Initial meetings with the CGL are to be completed within 8 weeks of taking the original CPX date.
      2. The CPX retake examination is a 6-station OSCE that occurs no later than 3 months before graduation to ensure graduation readiness.
      3. Failure to pass this retake will result in a referral to the Committee on Student Promotions.  
  4. Referrals
    1. Students will 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. 
    2. In these cases, working with a CGL is highly recommended for ongoing development of graduation competencies but is not required for passing the CPX.
  5. ACE-PC Program: Students in the ACE-PC Program will follow an adapted timeline that fits with their academic calendar.
  6. The Committee on Student Progress will be notified of students not scheduling the exam within the announced scheduling timeframe.

        PROCEDURE

        1. The CPX is an 8-station OSCE that takes place primarily during the months of May and June of each year.
        2.  Rising post-clerkship students generally receive their assigned CPX test date from the CPX Director and CPX Scheduling Coordinator by March. 
        3. Rescheduling
          1. Students needing to adjust their scheduled CPX date can exchange their time slot with another student.
            1. Timeslot swaps must be completed at least 1 week before the scheduled CPX date. 
            2. Each student must confirm the schedule change with the CPX Scheduling Coordinator and CPX Director by email.
            3. The students must await confirmation of the swap by the CPX Scheduling Coordinator and CPX Director before proceeding with the timeslot swap.
          2. 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.
        4. There will be limited delayed administration of the CPX in December following the primary administration in May/June.
          • This administration is for students in the ACE-PC program as well as off-cycle students who were not eligible for the primary exam dates but completed at least 5 of 6 clerkships by the December exam date.
        5. CPX Outside of UC Davis
          1. In the rare instance that a student is not able to complete the CPX as outlined in the procedure above, the student must email the CPX Director and CPX Scheduling Coordinator at least 1 month before the UCD CPX cycle to request consideration for taking the exam at another CCAACC member school.
          2. The request will be reviewed by the Associate Dean for Students, the CPX Scheduling Coordinator, and the CPX Director.
          3. If approved, proper coordination of alternate testing site will be arranged by the CPX Director and the CPX Scheduling Coordinator.
          4. CPX completion must take place during the standard CCACC member school CPX cycle (April-August). 

        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 Advisory Committee
        Executive Director of Clinical Skills Education

        REVIEW DATE and CYCLE
        February 2025, annual review cycle

        * Indicates the Policy Owner