Moderator EMEDPA Posted August 8, 2015 Moderator Share Posted August 8, 2015 To the original post - you are not alone! I come from the days of #2 pencil and bubble sheets. yup, and a meaningful pance exam with 3 practicals and 3 written components over the course of boards week, not boards afternoon. Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted August 8, 2015 Share Posted August 8, 2015 yup, and a meaningful pance exam with 3 practicals and 3 written components over the course of boards week, not boards afternoon. Ah, the good old days of fretting... Sent from my iPad using Tapatalk Link to comment Share on other sites More sharing options...
Febrifuge Posted August 8, 2015 Share Posted August 8, 2015 ... due to my black and white thinking and detailed observations I noticed a mistake on the pnemonic for heart ... I am such a jerk, but I do it with love and I can't resist: it's mnemonic. Nothing to do with air ("pneumo-"). Mnemosyne was the mother of the nine Muses in Greek mythology, and herself was the personification of memory. Link to comment Share on other sites More sharing options...
Guest Paula Posted August 8, 2015 Share Posted August 8, 2015 No, no. You're not a jerk. I knew it didn't look right, but since I have a hard time remembering mnemonics why would I even be able to spell the word? LOL!!!!! Plus I was lazy and didn't look it up. I'm taking my 20 lashes humbly!!! Link to comment Share on other sites More sharing options...
TWR Posted August 9, 2015 Share Posted August 9, 2015 does anyone beside me see the angst that we have to take a written test that in the end does not indicate whether we are good at our job or not.. I think the fear is that if you don't pass that your option is to find a job in a new profession. There are better ways to determine if what we do every day year in and year out is up to a "standard" that a wriitten test says we are competent. Are people that fail incompetent? Is an MS better than a BS + 25 years experience? Is a doctorate better than MS? I believe the written test which does not reflect what I do everyday for 30 years and is not an indicator as to whether I am a "competent" clinician or not. Yes I have taken 3 PANREs. No more. It is a big money maker!! Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted August 9, 2015 Share Posted August 9, 2015 does anyone beside me see the angst that we have to take a written test that in the end does not indicate whether we are good at our job or not.. I think the fear is that if you don't pass that your option is to find a job in a new profession. There are better ways to determine if what we do every day year in and year out is up to a "standard" that a wriitten test says we are competent. Are people that fail incompetent? Is an MS better than a BS + 25 years experience? Is a doctorate better than MS? I believe the written test which does not reflect what I do everyday for 30 years and is not an indicator as to whether I am a "competent" clinician or not. Yes I have taken 3 PANREs. No more. It is a big money maker!! Such as (if exam is not appropriate)? Sent from my iPad using Tapatalk Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted August 9, 2015 Moderator Share Posted August 9, 2015 Such as (if exam is not appropriate)? Sent from my iPad using Tapatalk passage of a CAQ specific to one's specialty every 10 years as a well as specialty and primary care specific cme...(!) Link to comment Share on other sites More sharing options...
TWR Posted August 9, 2015 Share Posted August 9, 2015 Competency is measured by what one does every day at work. Have they had a suit brought against them? Is the employer satisfied and more importantly are the patients satisfied?? Keeping up the 100 hours of CME is appropriate every 2 years and requiring attendence to at least one conference in the specialty that one works in would be appropriate. Written tests do not measure competency. After the initial PANCE following 2 + years of "school work" and clinicals is appropriate. Practicing for decades particularly in the same specialty measures and fine tunes ones competency IMO written tests make money, that's it. Maybe have a collaorating physician fill out and sign a "competency" form every two years. That plus the CME and conference attendence should be sufficient evidence to indicate competency. Just wonderering if Lawyers, dentists, podiatrists, optometrists, or for that matter NPs need recerification by written exam. The NPs have just moved way ahead of us as PAs with no exams just CMEs I believe. Link to comment Share on other sites More sharing options...
electric130 Posted August 9, 2015 Share Posted August 9, 2015 I completely agree with TWR. There could be another way to measure competence. I agree with an initial certification exam and then CME, reviews, CAQ if someone desires. It is a shame that we have all of this testing and CME requirements but are less independent than NPs. Speaking of making money the new CME requirements are a pain too. Just another hurdle that is costly and more complicated than it needs to be. Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted August 9, 2015 Share Posted August 9, 2015 Personally, I see nothing wrong with having to take an exam every so often that deals with CORE knowledge for general medicine. Some of the abstract questions asked on PANRE are ridiculous in my opinion. We should never lose CORE knowledge regardless of our number of years or specialty area. Examples: causes of URI's, primary/secondary treatment options in the less common chance that they are actually bacterial (and recognizing that most are viral); UTI causes/tx, basic GI s/s/tx., throw in pt. scenarios in which one should be able to identify urgent/emergent conditions that may mimic more common, less severe, problems; basic review of clinical exam findings and their implications (Bates PE textbook questions as an example). In other words, if you lose basic, core knowledge then how much medicine do you actually know? Link to comment Share on other sites More sharing options...
TWR Posted August 9, 2015 Share Posted August 9, 2015 GMOTM, That's how the questions used to be on the PANRE before the change 4 years ago. I still do not believe a written test is necessary. If you don't know your "core" medicine, then you would have been weeded out anyway by your "consulting" physician. or some malpractice lawyer. I suspect you have not practice many years. Just a guess based on your answers. CME and attendence to a conference every 2 years should be sufficient to measure cometency. Incompetence will always be found out no matter what the profession. Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted August 9, 2015 Share Posted August 9, 2015 Only 32 years. I speak from first hand experience having mentored a grad from eight years ago within the past year that didn't know how to do an eye examination with an opthalmoscope. Some of the questions brought up by a co-worker who went to a prestigious program regarding what antibiotics can be used for common conditions also gets my attention. Just because you graduate from a program doesn't mean that you know your arse from a hole-in-the-wall, and no, passage of today's PANCE doesn't qualify in comparison to what EMEDPA and myself were referencing from decades back as to how it used to be done with practicals and such in addition to a written examination and case scenarios where you used highlighting text markers to reveal your answers. Just because someone sits in a lecture hall at a CME conference doesn't always mean that "the lights are on". I don't think that ANY professional should be able to forget the most basic concepts of their profession. You can't do trig/calculus without understanding basic math. One other observation. Knowing how PANCE is different now from the 70's/80's, I find it ironic that they have made the INITIAL certification process "easier" from the perspective of lesser involvement/demostration, yet have made PANRE/recertification requirements more difficult. It seems that it should be the other way around, IMO. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted August 9, 2015 Moderator Share Posted August 9, 2015 having taken pance and panre 3 times (most recently in 2014) I can't say that the test has changed significantly over the years. panre has never been a very good test and has always been filled with needless zebras. I always score very well, so suspect that a lot of those zebras are "test questions" that don't get counted in the final analysis. GOTM- I never took the "highlighter" version of the test but know about it. when I took pance it was still on paper and had 3 written tests in primary care, surgery, and core medical knowledge plus 3 practicals. we took it over the course of a week. youngins have it easy today with a single computer based test that can be done in an afternoon. damn kids! get off my lawn! (said while gumming banana....:) ) Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted August 9, 2015 Share Posted August 9, 2015 The highlighter portion was interesting. It allowed you to work your way through a patient but if you messed up you knew it right away and it would take you back to an earlier step. I think I will go out into the garage now and work on my Gran Torino. Sent from my iPad using Tapatalk Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted August 9, 2015 Moderator Share Posted August 9, 2015 The highlighter portion was interesting. It allowed you to work your way through a patient but if you messed up you knew it right away and it would take you back to an earlier step. I think I will go out into the garage now and work on my Gran Torino. Sent from my iPad using Tapatalk great flick! Link to comment Share on other sites More sharing options...
TWR Posted August 10, 2015 Share Posted August 10, 2015 GMOTM My bad. More surprised that after 32 years, you need a test to see if you have core knowledge. I too took the exam and did both the primary care and the surgical core in 1986. Thanks to good prep from program I scored in the top 10% in both primary care and surgery. If I had been out of school for 10 or more years, that would not have been the case I am sure. As a student, you are used to tests weekly/ daily. In the real world, not taking a test in 6 years means going back to being a student and balance your practice and personal life and wondering if you fail what will you do to support your family etc. I also precepted PA students for 6 years in my practice in NY as well as FP residents. Somehow, those days were more fun than life today practicing in Houston. Link to comment Share on other sites More sharing options...
MediMike Posted August 10, 2015 Share Posted August 10, 2015 That's kind of an insulting way to come at that statement. May be speaking out of turn here, but after interacting with GMOTM on the board for a number of years I highly doubt there is any doubt in his/her mind that they have maintained the core knowledge necessary for this profession. I look at all types of recertification requirements, both CME and tests, as a failsafe to prevent those who shouldn't be practicing from slipping through the cracks. It's pretty naive to think that just because you paid for some CMEs that you actually either paid attention to, or retained, the information. There needs to be some time of evaluative process in place to guarantee that you know what the hell you're doing. And no, having a report card filled out by a collaborating physician doesn't cut it. Becomes a subjective evaluation at that point rather than objective. Also you can practice crap medicine and never have a suit brought against you. So while that test format may consist of a generalized exam such as the PANRE or CAQ style specialty specific tests, there has to be something. Sucks that it induces so much angst for people, but it's the nature of the profession. Link to comment Share on other sites More sharing options...
RealityCheck Posted August 10, 2015 Share Posted August 10, 2015 One of my main problems with the recert tests over the years has been the ambiguous questions and the ones where "book answers" don't meet real answers. My lowest score on one test was psych - why? - more than half the drugs are used off label or in weird combos. The test also assumes that one has access to resources that actually do not exist. So, my answers were based on what I DO not what some book says. The psychiatrists I work with support my medication decisions 100% and they are who I learned it from. So, am I bad at psych - NO. The other questions that drive me insane are the "what is the FIRST thing you would do?" - ok, chest pain - MONA. Well, I am not alone and I am not out in the woods - so the patient is already on oxygen as I enter the room and has probably already chewed the ASA and the monitor is on and the IV is being put in. Sooooo, how do you want me to answer this? The FIRST thing I would do is introduce myself to the patient and ask what they are feeling and determine that they are conscious and have a pulse. There is no right answer to these questions. Also, any questions that ask "what one thing can you do for this patient?" - the answer is ALWAYS - stop smoking. Seriously - duh. I found drugs on the test that seemed to have a regional flavor and were not in Sanford's guide or on any list as most commonly used. I have questioned NCCPA for years on where they get this information and who makes the test questions. It has never reflected what I do or what I learned or what I see in my community. And that survey that NCCPA sent out that I got 1.5 Cat I CMEs for - useless, absolutely useless if they think it will help with PANRE test questions. So, my two cents is that the test needs to be reviewed by a LARGE panel of long time practicing PAs from all over the country who are allowed to tear questions apart and give feedback and data and real information so NCCPA can see reality, not some book, whatever book that may be. Time for a reform in my opinion. Link to comment Share on other sites More sharing options...
cinntsp Posted August 11, 2015 Share Posted August 11, 2015 So, my two cents is that the test needs to be reviewed by a LARGE panel of long time practicing PAs from all over the country who are allowed to tear questions apart and give feedback and data and real information so NCCPA can see reality, not some book, whatever book that may be. Time for a reform in my opinion. Do keep in mind that the scoring model for these tests is based on your performance relative to your peers in the same testing group. You won't be greatly affected by a bad question that most people miss. Link to comment Share on other sites More sharing options...
marktheshark89 Posted August 11, 2015 Share Posted August 11, 2015 I'm all for continued testing. I think it adds face validity to the profession if nothing else and also keeps us in line with physician recert every 10 yrs. That being said, I think that an initial pance followed by a specialty exam and your area of work makes more sense. Similar to initial step 1/2/3 for docs, followed by recert in their residency/fellowship trained area of medicine. Link to comment Share on other sites More sharing options...
db_pavnp Posted August 11, 2015 Share Posted August 11, 2015 Do keep in mind that the scoring model for these tests is based on your performance relative to your peers in the same testing group. You won't be greatly affected by a bad question that most people miss. Isn't this just a copout for making a lousy test, though? It doesn't hurt you, so who cares? Link to comment Share on other sites More sharing options...
cinntsp Posted August 11, 2015 Share Posted August 11, 2015 Isn't this just a copout for making a lousy test, though? It doesn't hurt you, so who cares? I don't think it's an excuse to have a sloppy test but my point was that a few bad questions won't really hurt someone. That's assuming they really are bad questions, in which case you would expect a large percentage of testers to miss them. A standardized test can't account for local practice differences, so the textbook answer will be the right answer despite how weird it seems. The poster I quoted mentioned psych meds, which aren't a huge part of the test anyway. Sent from my Nexus 5 using Tapatalk Link to comment Share on other sites More sharing options...
RealityCheck Posted August 11, 2015 Share Posted August 11, 2015 cinntsp - Unless you have the statistics on which questions a majority of folks missed - I think you are missing the entire point. The test is flawed and doesn't represent what - across the board - PAs are facing clinically. I suggest a reform to the test and completely support going back to a 3 day PANCE with mock patients and clinical skills testing. I am 25 years in and have tested multiple times - I LOVED Pathway II and felt it was actually educational. I do not think the PANRE is reflective of what PAs know, should know or need to know. "A few bad questions won't really hurt" is NOT the point. Link to comment Share on other sites More sharing options...
cinntsp Posted August 11, 2015 Share Posted August 11, 2015 cinntsp - Unless you have the statistics on which questions a majority of folks missed - I think you are missing the entire point. The test is flawed and doesn't represent what - across the board - PAs are facing clinically. I suggest a reform to the test and completely support going back to a 3 day PANCE with mock patients and clinical skills testing. I am 25 years in and have tested multiple times - I LOVED Pathway II and felt it was actually educational. I do not think the PANRE is reflective of what PAs know, should know or need to know. "A few bad questions won't really hurt" is NOT the point. I am not against reform but I was addressing your complaint that the test has unrealistic questions. My point was that based on the scoring model, a few bad questions won't hurt you. Sent from my Nexus 5 using Tapatalk Link to comment Share on other sites More sharing options...
RealityCheck Posted August 11, 2015 Share Posted August 11, 2015 Never mind - we aren't on the same page. I am saying the test has NO really good questions if you look at clinical reality..................... Agree to disagree Done Link to comment Share on other sites More sharing options...
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