Failed PANRE miserably

[d2305]

Barbara Barzansky, PhD, MHPE, Illinois - NCCPA Chair

Wanda Gonsalves, PhD, South Carolina - American Academy of Family Physicians

John H. Stuemky, MD, FAAP, Oklahoma - American Academy of Pediatrics

John Davis, PA-C, Tennessee - American Academy of Physician Assistants

Paul Lombardo, MPS, PA-C, New York - American Academy of Physician Assistants

Frederick C. Blum, MD, FACEP, West Virginia - American College of Emergency Physicians

Patricia Cook, MD, FACP, Canada - NCCPA Chair-Elect - American College of Physicians

Richard Turnage, MD, FACS, Arkansas - American College of Surgeons

John T. Hayden, MA, Michigan - NCCPA Treasurer - American Hospital Association

Claudette Dalton, MD, Virginia - American Medical Association

Joel A. Kase, DO, MPH, Maine - American Osteopathic Association

Victoria Kaprielian, MD, FAAFP, North Carolina - Association of American Medical Colleges

Mark Christiansen, PhD, PA-C, California - NCCPA Executive Committee Member at Large - Physician Assistant Education Association

Mary Warner, MMSc, PA-C, Connecticut - Physician Assistant Education Association

Ellen Harder, PA, Washington - Federation of State Medical Boards

Denni J. Woodmansee, PA-C, Massachusetts - U.S. Department of Veterans Affairs

PA Directors-at-Large:

James D. Cannon, DHA, MBA, PA-C, Virginia - NCCPA Secretary

Erich Fogg, PA-C, MMSc, Maine

Jennifer R. Madonia, MS, PA-C, Connecticut

Varnell D. McDonald-Fletcher, EdD, PA-C, North Carolina

Public Directors-at-Large:

Linda Golodner, Washington, DC

Cynthia Griggs-Flournoy, FACHE, RHIA, MS, Georgia

Janet Lathrop, MBA, Georgia - NCCPA President

[dm123]

My opinion: For all practical purposes, the NCCPA is an entrenched bureaucracy. Early on, a case could be made that it promoted the profession by a form of quality control visible to those outside the PA profession. As is often the case, they have lost sight of their original mandate for whatever reason, be it self aggrandizement, their on job security, or finances. Whatever the reason, a chain needs a bit of jerking.

 

My wife's professional organization (she is a CRNA), had to fight tooth and nail a proposal a few years back to prevent a requirement that CRNAs be required to undergo re-current testing. Their political organization squashed it like a bug. CRNAs, as well as NPs must maintain CEUs in their chosen field but have no re-certification tests. PAs would do well by adopting nursing political models of operation. CRNAs, as a group, are smaller in numbers than PAs but have learned how the in-your-face political games are played.

 

If the AAPA will not go to bat for the rights of PAs, start a new national organization. Sometimes even the threat of a new kid on the block gets people off their duff. Competition can be a good thing. I could not believe a post I read here about the AAPA not pitching in when a state organization (West Virginia I think) tried to get legislation passed and the AAPA actually fought the state's measure, seemingly because the AAPA wasn't involved from the start.

[chatcat]

Great reference list d2305 provided. Again,where is the oversight/cordination by our national organization,AAPA?

Quite honestly, a web site that looks nice, and the addition of state of the art exam centers

counts for very little when NCCPA sends out form letters to those who contact and pose

valid questions regarding their testing scores.

Once again,bureaucracy excels in making a process much more complicated than needed.:-_-:

[HopefulPA]

Although I still have a while until I have to do the PANRE, this thread is pretty scary. There absolutley needs to have some sort of appeal process or exams rechecked. While I understand that everyone that fails would like to shift the "blame" to the test being unfair could be costly to recheck the exams. But from what I read here, these well seasoned PAs are all saying the same thing, from the same testing dates from different places. At least in my opinion egough to warrant a second look to say "maybe there is a problem with the exam" (either questions that are poorly written or a problem with the keying etc....)

 

But here is the thing what is NCCPAs incentive to change one darn thing? Nothing they got us. We have to recert and only they can do it. Unless there is some kind of legal action there is no incentive to change. From the numerous posters that failed almost all of them have said basically "can't fight city hall" so I guess I will just pay my money and take the test again. Unfortunately this does nothing to prevent the next PA from having to do exactly the samething. If however this group was to unite and try legal action against NCCPA then maybe the proper appeal process would be put in place thus providing some protection for our profession. It only takes 1 group to do this.

 

You know when I was in PA school we were always told don't make waves with the Physical Exam Profs. Well guess what I did and I got them to make changes that benefitted not only my fellow students but future students as well. I had good grades but there was a major flaw in that we received no feedback on perfomance exams. either you passed or you failed and if you failed you were not told why you failed. Although I passed all mine I kept pushing for feedback (i.e. how does a person know if they are not perfoming X of the physical exam correctly unless someone tells you) There was even a time when everyone in that was tested in Exam room 5 got either a significantly lower grade and or failure from previous exams, I was one of them and even though I passed I would not let it drop because the grader was not even watching me do the physical exam, most of the time he was looking out the window! Thankfully these are all video taped. But the profs were resistent to regrading them. I went to the program director and said the next step would be the dean. Turns out they found that the grader was not paying attention and actually was told they would no longer be a grader (apparently this was not the first time they had this problem with this grade for the same thing). Everyone in room 5 was regraded and most went from a failing grade to passing. Why because I would not let the issue drop. And resulted in a policy that anyone who fails automatically their video is reviewed by a different grader. So the result change from failing to passing and a change in the policy.

 

 

So I really really hope that for those that have taking the PANRE and failed (or even those that passed but thought the test was not what it should be) that you stand up and make a difference. Sure pay and resit so you can maintain the "C". But unless someone fights no change is likely to happen. Hard for those of us who haven't taken the test to make a stand but I'd be happy to sign a petition in support of change.

[SmokeyBear]

.... CRNAs, as well as NPs must maintain CEUs in their chosen field but have no re-certification tests. PAs would do well by adopting nursing political models of operation.

 

I was under the impression that NPs did have to re-certify. So, I looked it up... Looks like if they don't meet their practice hours and their education hours, then they have to recert... Otherwise they dont have to test again.

 

I really like that. Who starts this petition, and where do I sign?

[MMiller]

I was under the impression that NPs did have to re-certify. So, I looked it up... Looks like if they don't meet their practice hours and their education hours, then they have to recert... Otherwise they dont have to test again.

 

I really like that. Who starts this petition, and where do I sign?

 

I will sign as well, but I would defer the origin of said petition to someone with more knowledge on how to organize it.

[julia74]

Totally agree with petition idea.

[dm123]

Sent a note to the AAPA about concerns expressed by many over how the NCCPA is handling the PANRE a few days back. Haven't heard a thing in response yet. I'll give 'em till next week and then be a pest about getting so sort of response.

[rev ronin]

The problem is the NCCPA holds all the cards--the AAPA appoints one board member, as does the PAEA, IIRC, but the NCCPA board is not responsible to either org, and it's the one that's written into most of the state statutes...

[chatcat]

Sent a note to the AAPA about concerns expressed by many over how the NCCPA is handling the PANRE a few days back. Haven't heard a thing in response yet. I'll give 'em till next week and then be a pest about getting so sort of response.

 

Please keep us posted on the response from NCCPA.

It's stressful enough preparing for PANRE once but I can't imagine having to gear up again for a retake without meaningful

feedback about areas of weakness.

 

NCCPA's mission statement:Our mission is to serve the public through exemplary programs that evaluate critical PA

competencies and that require the pursuit of life-long learning and improvement. "

 

If indeed NCCPA stands by their mission statement then they absolutely should promote a plan for promotion of improvement

of any specific competencies that are needed for those who do not pass.

[berfenur]

hello everyone, I also failed the PANRE. I took the 240 question format in July 2011 and couldn't believe the results. What was more shocking than this is that two of my colleagues also failed with scores in the low 200's. That's when we start searching and found the PA Forum. It sounds like many people failed with the very low scores. I believe that I spend enough time to study and I did many test questions. The other 2 PA's had written email's and called NCCPA but they both received the same email that everyone else in this forum gotten. I also just found out that a 3 PA at work failed also. I'm hopeless. I just cant imagine sitting for this test again.

[dm123]

I have not gotten a response from the AAPA from a note sent a few weeks back. I sent a note to the Board of Directors. Maybe they haven't met yet.

 

I was talking to a practicing PhD psychologist friend at lunch a few weeks back. We discussed certification exams in general and the format used for various professions. He told me many of the computerized exams used these days are different than they us to be in the color the dot days. The exams used by some testing agencies vary the questions depending on the test takers response to a specific or group of questions. His opinion was that if a person answers a question correctly, the computerized test would then bump the complexity of the next question. The reciprocal being if the test taker missed a group of questions, they would hit an easy patch. I can't imagine this being the case with the PANRE but without oversite or even a response from the NCCPA, who is to know. The knowledge base for medicine is said to turn over every 5-7 years. Questions need to be current without tricky wording, like "pick the one best" unless the question is clear cut, and not graded using a Bell curve designed to fail a given number. It isn't like Algebra or history ( though I sometimes wonder about the book writers trying to change history).

 

I suspect the NCCPA advisory board is for the most part figureheads. The real power lies with the test writers.

[bobuddy]

Berfenur - can I ask which test you took - primary medicine, adult or surgery? I am heading to the Chicago review next week and have planned on taking boards early Sept - but now I am having doubts about taking it after seeing all of this. I have been in practice for 12 years and this is my second PANRE. I am taking it in my 5th year, so if I have to take it again I can. But I really dont want to do this more than once. I have always scored well on my other boards, but now I am freaking out. I purposely went into Primary Care so boards would not be a big issue in the future.

[maryfran123]

Alright, I continue to read this thread and continue to get freaked out.

I can honestly say that in my 24yrs as a PA-C I have had only a mild amount of anxiety about PANRE.

This thread has SIGNIFICANTLY changed that!!

1st PANRE took the written, not yet computerized exam, 2nd PANRE took pathway II, and last recert took PANRE on the computer for the first time. I took Drexel's board review course prior to my last PANRE and took the exam the next day. The other times no prep. I had no issues with any of these exams, scoring quite high, said as a point of reference to my upcoming point later in this post, not to brag.

 

My plan was to take DeSales 2 day prep course and take the exam but I'm really starting to rethink this. My colleagues are teasing me because they insist "i have nothing to worry about, you can take any test cold and do great" Well, I really am not feeling that way after this thread but likely will bit the bullet, dive in head first and see what happens. I want my prep to be consistent so if I score poorly I don't have any new variables to account for other than the new exam.

 

Based on all the reported failures on this thread I'm assuming that the overall failure rate for PANRE is higher than prior years, above the previous averages. This should be a red flag to the NCCPA. In the hospital, when an event is so out of the norm or raises a red flag, it is deemed a "sentinel" event and is agressively and thoroughly investigated to find the underlying cause. If NCCPA discovered the failure rate increasing, why aren't they on alert for this and checking into it?

 

What would be even more interesting and informative still would be to have NCCPA compare long time PA's PANRE (eg: those who have taken PANRE at least twice) scores to their current scores, especially the "failures". If there is a statistically significant deviation, that too should prompt a review.

 

Will post re: my pass/fail. Would be willing to sign a petition and if I end up not passing, maybe Contrarians idea of class action isn't unreasonable, especially if the NCCPA won't do more to investigate their role in the upswing of failures.

[Contrarian]

This should be a red flag to the NCCPA. In the hospital, when an event is so out of the norm or raises a red flag, it is deemed a "sentinel" event and is agressively and thoroughly investigated to find the underlying cause. If NCCPA discovered the failure rate increasing, why aren't they on alert for this and checking into it?

 

Because they don't need to... They are out of touch with clinically practicing PAs and no test is required for them to take to maintain NCCPA employment/their livelyhoods/food on their tables.

 

They are "accountable" to no one... and probably haven't really paid any attention because it doesn't affect them... as they are likely use to folks "whining" about not passing tests.

 

Pretty much what ya get when you got a organization of mostly "bureaucrats" standing between us and the general public.

 

Interestingly enough... bet those nurses and physicians wouldn't allow a organization full of "bureaucrats" to hold the "keys to their kingdom."

 

bureaucrat [( byoor -uh-krat)]

Someone who works in or controls a bureaucracy. The term is often used negatively to describe a petty, narrow-minded person. An official who works by fixed routine without exercising intelligent judgment.

 

YMMV

 

Contrarian

 

P.s...

Has anyone thought to make sure EVERYONE on that NCCPA Board list above has a active link to this thread...???

[dm123]

I had an idea (sometimes my brainstorms turn into rain) for a possible way to measure the competency/appropriateness to evaluate the PANRE exam.

 

Pull 25 (50 would be better) questions from the bank of questions, at random, from those used for the PANRE at NCCPA. I’ve hear the NCCPA had something like 1,100 plus in their bank of questions; they should be able to cough up a few without compromising there question base that much. As part of a CME conference involving MDs and DOs of varying specialties, ask them to answer the questions. They don’t have to identify themselves, only their specialty and time out of their residency. When scoring, kick out all those who haven not been away from residency more than six years. (PANRE people are out of school at least six years). Ask them to avoid collaboration with others nearby. It would be OK to tell them their answers would be used to evaluate the current testing requirements for PAs. Maybe give them ½ hour CME credit. After all, it would be a learning experience, even if they were not given the correct answers. Get a sampling from maybe 10 meetings around different parts of the USA. I would think the NCCPA would be receptive to finding out this kind of information. There are many CME companies that put on CME conferences around the country. Try to give the “tests” as near as simultaneously as possible. Maybe give the CME promoters a few bucks for their time and effort. It shouldn’t cost that much.

 

Trying to control all variables probably wouldn’t be practical doing this type thing on the cheap but if the indicator was there a better controlled study could be set up.

 

PAs should not be held to a standard higher than docs. If a ratio/proportion of the docs “fail” the test, then NCCPA needs to seriously look at the standards they are using to measure competency given their mission statement.

 

A sideline benefit would be to help educate the docs on the quality of PAs. Most of the ones I know are only vaguely aware that PAs have to take an exam every six years.

 

 

 

Any thoughts?

[rev ronin]

Any thoughts?

 

NCCPA has a monopoly mandated by law. Why on earth would they do any such thing?

[Simkin]

Ok, I have so many questions for the NCCPA and plan on recontacting them (with copies to the AAPA) once I can organize my thoughts into a meaningful letter. So I thought I'd post here first to see if anyone has any answers/comments/suggestions. See, I am having a difficult time studying all over again for this exam. The first go-around I scored high on my preparatory practice exams therefore was shocked with my score in the 200's because it was so grossly different from my pre-tests. I also had several astute PA colleagues who took the PANRE before the June change who each scored in the 600's despite consistently scoring lower than me (only ~65%) on the practice tests. This unexplained disparity, all of the above posts, and the NCCPA's lack of response lead me to believe without a doubt that there is an error somewhere. I do not mind putting the work into studying but I need to understand what happened in order to take the exam without fear of the same thing happening again. The scary thing is that based upon the PANRE questions that I can remember, I don't think that studying more would do any good. It's not as if I forgot the material...the material for some of those questions just isn't in the study guides.

We, the PA community should be told how the test questions are determined.

1) How is the blueprint exactly generated? For example, are there separate banks of questions from each subject area, like heme, OB/GYN, GI, peds etc. and then each test gets a % from each bank added to it randomly? Therefore no two PANRE's would ever be exactly the same.

2) How specifically are the questions weighted to be entered into this convoluted mathematical formula that generates our scores? (For example a minimum score of 379 on a 240 question test). The NCCPA can spew out the formula but it doesn't really matter unless it is clear how the weighting for each question is determined. And if no two PANRE's are exactly the same then how can one know that each PANRE is weighted the same?

3) What if these "new" questions are not reasonable to test basic skills...ie, not good questions - if randomized to come out of test banks then by chance one PA could get more "bad" questions and another PA get "old standard" questions.

4) Is there control on how many "new" questions get into the test from each subject bank?

5) Has the $35 practice exam of 120 questions offered by the NCCPA been updated to reflect the newer questions/format?

6) Are test questions pulled from the same banks for both PANCE and PANRE?

7) How old are the exam questions?

8) Why did they do away with the Pathway II? This answer does not really aid us but more speaks to the fact that the NCCPA is not accountable to us, the PA community.

9) Why has the "PANRE Comparison Table" (given to us with our exam results so we can see how we measured up to that of other PA's) not been updated in 4 years!!!! Quote - "* This table is based upon the reference group which comprises 3982 candidates taking the PANRE for the first time in 2007". How can my score be compared to one of a test from 4 years ago with 300 questions instead of 240 and compared to PAs who have only been out of school for 6 years????? How can this possibly be a good comparison? And how can we know that the "Standard Deviation and Average % of Items Correct" numbers provided with our score report are actually based upon our current peer's results when we are blatantly given a chart comparing us to PA's result in 2007?

10) What is the process to challenge a question? Why isn't there a way to do so?

11) **** What has been the pass/fail rate since the change in exam 6/1/11?*****

 

I want to say THANK YOU to those on this forum who have provided meaningful input who are not in the same boat as us who have failed. It would be easy in today's busy world to turn your backs and say, yeah there looks like a problem but glad it wasn't me. Imagine how it must feel to prep well, score high on all the practice exams and receive such a shockingly low score, knowing some mistake has been made. I recently purchased DataChem questions and am scoring well. You'd think that would make me happy but it doesn't. I'd rather have low scores so I would understand how I need to study to improve. Instead I am at a loss and frightened. I waited until the 6th year so I only have one more shot.

 

It's disturbing that there is no apparent watchdog over the NCCPA. There is no transparency. They should at least be willing to get on the phone or give meaningful feedback to those that need it to encourage continued education, competency and proliferation of our profession.

 

Interesting side-note: According to AAPA website there are 72,433 practicing PAs for whom they have a mailing address (which means there are likely more). If each pays the NCCPA $350 every 6 years, that is $4,225,258 revenue each year by the NCCPA (72,433 x $350 = $25,351,550/6 + $4,225,258). Add in $2,897,320 annually received from our $80 every 2 years certification maintenance and that's revenue of $7,122,578 a year....and they cannot even pick up the phone when we call their little office suite in Georgia? (I understand their profit is less than 7 million a year due to expenditures such as office rent, payroll for a small staff, testing center fees, website maintenance). But Holy cow. Food for thought.

[pamb77]

I'll sign a petition if anyone writes it up.

[dm123]

Simkin--great questions.

 

“NCCPA has a monopoly mandated by law. Why on earth would they do any such thing?”

Maybe to verify the integrity of the NCCPA. One of the most difficult classes obtaining a BS in psychology was entitled “Tests and Measurements”. Designing tests, questionnaires and the like is tough. Innuendos of language and language skills and heritage of the test taker and many other variables play havoc with designing appropriate questions. Put someone from East Tennessee, Brooklyn, a Brit and a New Orleans Cajun at a diner table and you end up finding out much about the English language. I once ordered a milkshake from a northern restaurant near the Canadian border and got a glass of warm shook milk. Are the questions applicable to what the tester wants to measure? Should pass/fail scores be weighted for ethnic or racial reasons? Are the answers vague or confusing?

 

I would like to think the NCCPA would WANT a method of verifying or making their tests more applicable. Checks & balances should be part of an honest quest to do the right thing, if not by this method, then by something to insure they are fulfilling their mission. What have they got to lose? They were able to survive ten years ago with half the numbers of PAs furnishing funds so money shouldn’t be an issue. In today’s dollars I suspect they are pulling in over $5,000.000.00 a year based on test fees and total PAs nationwide, even if everyone passed on the first go-round. I would also suspect, but haven’t found searching the IRS, that they have non-profit 501-C status of some variation. Tax exempt or political organizations (excluding churches or similar religious entities) must make their returns, reports, notices, and exempt applications available for public inspection. I would think there would be something referencing NCCPA on IRS.gov but the IRS website is a quagmire of information. Curious as to where all this money is going in our modern day of computer testing. It isn't like it use to be with hand scoring. I would also be curious if money had something to do with eliminating Pathway II for re-certification. Depending on feedback, I plan to try and get some amount of info from the “horse’s mouth’. That’s colloquial, Southern speak for ‘MMFIC’, big cheese or whatever.

 

Problem is going to be apathy of the PA group. The weight of complaints should come from those who have YET to have problems with the test. Human nature is such that this group will also have a somewhat superior feeling about themselves until it happens to them. I never studied in the past for the PANRE and had no problems, one time came close to the not pass but since it was a pass didn’t pursue any further. I’m definitely not the sharpest arrow, just lucky and tested on good days. I suspect that won’t be the case when I next take the test, if I’m still around to take it (darn brainstem lesions). A comment from a PA in town “they must be pretty dumb to have failed the PANRE”. This comment was from someone who hasn’t tested lately.

 

It really is time PAs stopped allowing themselves to be pushed to the back of the bus. The *****ing should come from those who have been around for a while and not new grads. I remember how it was when I got out of PA school. No money, no job, piles of debt. New grads can’t afford to make waves.

 

I would also love to find out if the questions for the PANCE and PANRE are pulled from the same bank of questions.

[bradtPA]

I still think the most important question to ask NCCPA involves the pass/fail rate. If 96% of all PAs are passing, and last year 96% of all PAs passed, then I really don't see that there is a problem with the test. if the rate has dropped from 96% to 85%, then that is relevant....

[Contrarian]

I agree with that notion BradtPA... but reporting a number and ensuring transparency is two entirely different things.

NCCPA needs to instill some transparency and "stonewalling" concerned PAs (their sole reason for existing) SHOULD-NOT BE reflexive...

[chatcat]

Just heard this news "through the grapevine" and wanted to share.

NCCPA will be changing the PANRE exam to every 10 years beginning in 2014.

Best news I have heard in a very long time regarding our certification requirements!

[PAinMaryland]

Simkin,

 

Good work with questions. However, I really doubt they will take the time to answer any of them. I am in the same boat as you and took the exam around the same timeframe (end of June). I too am having a difficult time studying as I feel that I know the material already and the exam score I received doesn't reflect my performance. My correspondence with NCCPA has been futile as of course they deny anything wrong with their procedure. As many have mentioned, there is no recourse for NCCPA to behave in such a manner and since they don't answer to any stakeholders, they can keep all their mistakes hidden. If any petition is filed for re-grading or auditing of scores from the mentioned timeframe, please count me in.

[dm123]

I still think the most important question to ask NCCPA involves the pass/fail rate. If 96% of all PAs are passing, and last year 96% of all PAs passed, then I really don't see that there is a problem with the test. if the rate has dropped from 96% to 85%, then that is relevant....

 

Agree, only a year might be to long a time frame. Rounding off numbers, 72,000 PAs re-certifying every 6 years means 1,000 a month are testing. Even a thousand is a lot of pain and suffering needlessly if a problem exists. I would think even a weeks worth (250) in our computerized age would be enough to smell a problem. Access by NCCPA of test scores should be available in 24 hours, maybe less with a program to flag a variance in cumulative scores.

 

If exam criterion was changed in June 2011 as suspected or at any point if not the test takers fault, those failing due to errors of NCCPA should be given a pass. It is not like they haven't taken and passed the PANCE at some time, and kept there CME's up to date.