It is difficult for me to believe, but after just 10 short months, my first year of PA school is almost over.
With little more than a week left, I have found myself reflecting more and more on how much I have learned since last August. The medical knowledge I have gained is invaluable to me and has helped me form a strong base on which to build my skills during upcoming clinical rotations.
In addition, I could not possibly reflect on the past year without mentioning the wonderful friendships I have formed with my classmates. We have spent every day, all day, working through a demanding curriculum together for nearly a year and I am so grateful for their support and encouragement through the process. Though we will miss the company of each other next year during rotations, I have no doubt that the close friendships we have formed will be lifelong. But, before getting too sappy, there is still work to be done and new things to learn over the next week to complete the year.
The last CPX
After a recent morning lecture, everyone was scheduled throughout the rest of the day for our last Clinical Performance Examination (CPX). CPXs are distributed throughout the year and all involve a simulated encounter with a standardized patient, who is a trained actor following a script. The purpose of a CPX is to practice problem-focused patient assessments that correspond to the current unit in the curriculum. For example, the standardized patient may have a chief complaint of shoulder pain during the orthopedics unit. As the student, I have 15 minutes to take the patient’s history, do a focused physical exam, and provide a tentative assessment and plan.
Luckily, my scheduled CPX time was a few hours after the morning lecture so I had some time to review my notes. This CPX corresponded to the geriatrics unit, so as I read my notes I tried to think about possible chief complaints and corresponding physical exam techniques for that population.
A few minutes before my time slot, I grabbed my white coat and stethoscope from my locker and waited for the overhead prompt to enter the exam room. I heard the prompt and quickly read the chart outside the door, which typically includes patient name, age, basic vital signs, and a chief complaint. My time had already begun so I took a deep breath, knocked on the door, and entered the room. The standardized patients are all highly trained and the mock exam room was so realistic that I had no problem imagining this as a real encounter.
Fifteen minutes felt more like five and before I knew it, the visit was complete and I exited the room feeling satisfied with my assessment and plan. After I left, the standardized patient filled out my evaluation and provided feedback on both my clinical and interpersonal skills. The feedback is extremely helpful in providing positive feedback and suggestions to improve future encounters.
Feedback and progress
Probably the best part about the CPXs is that they are recorded so that we are able to watch the encounter from a different perspective. Later that afternoon, I replayed the video and evaluated myself using a self-assessment tool. Like the comments from the standardized patients themselves, my evaluation is also quite helpful in improving both my verbal and non-verbal communication, as well as making adjustments in order to become more efficient at the history and physical exam.
Since this was the last CPX of the year, the self-assessment includes a section to compare this encounter to an earlier CPX. After watching both videos, I was both amazed and proud at the progress I have made, both in clinical judgement and communication skills, since the first encounter. Comparing the two videos gave me a boost of confidence which is welcome since clinical rotations will begin very soon.
I know I still have much to learn over the upcoming year but I am finally starting to realize that I am more than prepared to step up to the challenge.