Clinical Performance Exam (CPX)

The Clinical Performance Exam (CPX) program includes two standardized patient (SP) encounter exercises – the Mini-CPX and the CPX. Participation in the Mini-CPX and CPX is required for all students. See the CPX Program Attendance and Professionalism Policies for information on expectations related to attendance and professionalism.

Mini-CPX: During Foundations 2 (during ARCH Week 6 or early in Block 5)

The Mini-CPX is designed to provide a mid-F2 skills assessment and prepare students for the CPX. It is an important opportunity for learning and feedback mid-way through Foundations 2. In the Mini-CPX, each student will rotate through three patient stations independently in the Kanbar Center. In the role of “student doctor,” each student is expected to perform a focused history and physical examination based on the patient’s chief complaint, generate a working differential diagnosis, and present an assessment and plan to the patient. Students receive verbal feedback directly from each standardized patient. Students also complete an interstation exercise for each encounter.

The major learning goals of the Mini-CPX are to:

• Establish rapport quickly and effectively with patients
• Generate a differential diagnosis based on chief complaint
• Perform a focused history and physical examination based on the differential diagnosis
• Communicate thinking/plan to the patient
• Treat the SP interaction as a real encounter in a clinical setting

All student encounters will be digitally recorded, and students are strongly encouraged to review their videos with their coach or another faculty mentor for further learning and feedback. All students will receive a score report indicating their scores on each of the cases in history taking, physical exam, information sharing, and communication skills. These individual scores will be compared to the class as a whole.

The Mini-CPX  is scheduled in late August through early September of Foundations 2, during ARCH Week 6 or early in Block 5, at the Kanbar Center. Students' total time commitment for three patient encounters and feedback is about three hours. F2 course directors will excuse students from course and clerkship duties for a half-day to participate. There are no implications for clerkship grades; the Mini-CPX is meant to be an opportunity for learning! The Mini-CPX is required for all students enrolled in F2. Participating in Mini-CPX will help improve performance on the CPX by familiarizing students with the CPX format. 

Students whose performance raises concerns about whether they have achieved a minimum standard of competence will be notified, as will their coach. We will refer those students to the optional Clinical Skills Guidance Program to work with a mentor to improve their skills. 

Clinical Performance Exam (CPX): early in Career Launch

The Clinical Performance Examination (CPX) is a standardized patient program required for all UCSF students after Foundations 2.

The three purposes of this exam are:

1. To evaluate students' current competence in clinical and interpersonal skills.
2. To provide individual feedback on these skills in preparation for sub-internships and residency training.
3. To evaluate the effectiveness of our overall curriculum.

The CPX is designed by a consortium of clinicians and medical educators from ten California medical schools to assess clinical skills essential to the practice of medicine regardless of specialty. More than 1000 students take this exam each year. During the exam, students will see about eight patients with a broad range of ambulatory problems. Similar to the Mini-CPX, students will be expected to communicate their thinking and preliminary plans to the patient. Students also complete interstation exercises or note writing focused on clinical reasoning for each encounter.

The exam is designed to be taken at the end of the core clerkships. Students who have completed at least four core clerkship blocks by the time of the CPX are required to take the exam; students who have completed three blocks are strongly encouraged to take it. Any student planning on extending their curriculum should plan on taking the CPX before taking time off.

The exam occurs during Career Launch Blocks 2 and 3. Students are scheduled for one 4.5-hour session in the Kanbar Center.

After the entire class has completed the exam, students will receive detailed feedback from the patient encounters and a set of scores with comparison standards. All students are encouraged to work with their coach or a faculty preceptor to identify strengths and make plans for potential improvement.

All students must pass the CPX before graduation. Students who do not achieve a passing score on the CPX will be notified, as will their coach. Students will be required to complete the following:

• Participate in the Clinical Skills Guidance Program. This includes meeting with a faculty mentor and participating in a clinical skills workshop.
• Take and pass the CPX Retest exam.

By completing the Clinical Skills Guidance Program and the CPX Retest, students will successfully complete the CPX program. They will have the same language in their MSPE as students who pass on the first attempt.

Contact info

For more information about the CPX Program, please contact Dr. Abbi Phillips, CPX director: Abigail.Phillips@ucsf.edu