1. PREPARING FOR PANCE Randy D. Danielsen, PhD, PA-C Professor & Dean Arizona School of Health Sciences A.T. Still University Former Chair of Board, NCCPA Presentation to the AAPA Student Track Monday, May 27, 2013 1:00-2:00 p.m. Sheila Mauldin, MNM VP of Exam Programs National Commission on Certification Of Physician Assistants

2. PA-C A mark of professional accomplishment – Emphasizes clinical practice knowledge – Requires knowledge of basic pathophysiology – Requires knowledge of basic health sciences – Core functions in which PAs should be skilled in primary care

3. Goal: Successful Passage of PANCE Three conditions are generally necessary for successful passage of PANCE: 1.Knowing about or recognizing the medical information contained in the questions, 2.Using appropriate test-taking skills and strategies, and 3.Avoiding situations that are likely to cause mistakes or impede performance. 1 1 Miller & Jarski, Test-Taking Skills: Tips and Techniques, Physician Assistant Examination, Lange, Edition 6, pg 1

4. Today’s Presentation Areas we will discuss today: How to study and prepare for the exam About the exam What to do during the exam, and What to do AFTER the exam

5. General Test Taking Tips Test-taking skills A purposeful, positive attitude Strategic thinking Planning Naturally, a solid grasp of the REQUIRED content

6. Let’s Talk about the PANCE Two dimensions: – Knowledge and skills areas (PA tasks) – Diseases, disorders and medical assessments of the organ systems Approximately 20% of the test questions will cover surgical issues. Up to 2% may be legal or ethical questions.

7. Percentage of Diseases/Disorders of Organ Systems

8. Percentage of Knowledge & Skill (Task) Areas

9. Test Development Terms Stem – The stem refers to any information preceding the response items. – The stem usually contains (1) a question or an incomplete statement/phrase to be completed by selection of a response option and (2) any information supplied to the student for use in responding to the item (e.g., case history, clinical vignette, statement or problem, lab values, PIX, etc.) Key – The correct answer (The GOAL!)

10. Test Development Terms Distracter – A distracter is any incorrect response in an item. A good distracter will “distract” a less knowledgeable student from the correct response. Item Type – Refers to the format of an item A-Type (type that’s on PANCE) K-Type (not included on PANCE)

11. Testing Recall versus Reasoning The development of examination questions varies in complexity according to the cognitive process the student must employ to identify the correct answer. There are generally two kinds of items: (1) recall (or memory) items, and (2) reasoning (or application of knowledge) items.

12. Testing Recall versus Reasoning Recall Items ask for the recognition of memorized facts or data – a one step process. Reasoning Items involve a cognitive process of three or more steps. A reasoning item asks the student to: – recall what is known about the problem at hand, – interpret/translate information that is recalled or that is presented in the stem, and – apply the interpreted information to arrive at a conclusion PANCE requires reasoning—not simple recall.

13. How to Study Your chances of doing well are directly dependent on a concentrated review effort. The key: Don't wait until the last minute. Begin your review early. To develop test-taking skills you must actively practice what you will be doing on the test---answering multiple-choice questions

14. How to Study Direct your studying to the primary care areas with which you are least familiar! How to do that? Take multiple-choice tests cold then go back and just study the areas that you missed. Some like to actually write their own questions as part of the study process.

15. When to Study NOW! Be aware of your best time of day. Many students learn best in daylight hours. Use waiting time: Five minutes waiting for the bus, 20 minutes waiting for the dentist, 10 minutes between classes – It adds up fast! – Have short study tasks ready to do during these times.

16. Where to Study Use a regular study area. – Your body knows where you are. When you use the same place to study, your body becomes trained. When you arrive at that particular place, it will automatically sense that it's time to study. You will focus your concentration more quickly. Don't get too comfortable. Put yourself into a situation where your mind is alert.

17. Where to Study Use the library. – Libraries are designed for learning. – Entering a library is a signal to your body to quiet the mind and get to work. Most students can get more done in a shorter time at the library.

18. Where to Study Set up study groups. – Forces you to articulate concepts and makes a review more fun and productive. – Keeps your review on schedule and helps you avoid procrastination. – Allows you to benefit from other students’ expertise A study group doesn't take the place of individual study.

19. How to Handle Life Pay attention to your attention span. Breaks in concentration are often caused by internal interruptions; your own thoughts jump in to tell you another story about the world. If this happens too often, perhaps you need to find a different study time or place. Agree with living mates about study time.

20. How to Handle Life Avoid noise distractions. Don't study in front of the TV. Turn off the stereo. Many students insist they study better with music, and that may be true. Some students have reported good results with carefully selected and controlled music. The overwhelming majority of research indicates that silence is the best form of “music” for study.

21. How to Handle Life Notice how others misuse your time. Be aware of repeat offenders. Ask yourself if there are certain friends or relatives who consistently interrupt your study time. If avoiding them is impractical, send a clear (but gentle) message. Sometimes others don't realize they are breaking your concentration.

22. How to Handle Life Get off the phone. – You don't have to be a telephone victim. Try saying, "I can't talk right now, I'm studying" or leave your answering machine on. Or, avoid the whole problem by studying at the library. Learn to say no. This is a valuable time saver and an important life skill. Many people feel it is rude to refuse a request. Saying "no" can be done effectively and courteously.

23. Getting Ready for PANCE Be prepared emotionally and physically as well as intellectually. Locate the test center the day before the exam. Find a center near you at www.pearsonvue.com/nccpa. Arrive at the site early, particularly if parking may be a problem.

24. More Details on PANCE

25. Where does it start? Exam blueprint is based on information obtained from the practice (job) analysis Conducted every 5-7 years Last one was completed in 2010 Panel of content experts (PAs and physicians) develop survey Survey consisted of over 200 questions Disseminated to over 80,000 PAs 19.4% response rate

26. How Exams Are Developed Item is written & edited Item is pretested on exam Item goes through key validation Item becomes a scored item on exam Annual review of item performance through key validation

27. Scoring & Analysis Each question counts equally. – Items are not weighted, nor are points subtracted for incorrect answers.

28. Scoring & Analysis criterion-referenced PANCE is a criterion-referenced examination.

29. Scoring & Analysis PANCE passing standards are not normative. If 100% of the candidates meet the specified passing criteria, then 100% will pass the examination.

30. Scoring & Analysis Periodically, the passing standard is evaluated. Standard setting committee is comprised of certified PAs and physicians who have experience working with PAs. – They review questions from the exam and develop a recommended passing standard NCCPA Board of Directors makes the final decision.

31. PANCE Details 300 multiple-choice questions, administered in five blocks of 60 questions 60 minutes to complete the test questions in each block (1 minute/item) Time Allotments: – Testing time = 5 hours – Tutorial time = 15 minutes – Break time = 45 minutes

32. PANCE Details Cost for the exam - $475 After applying, you will have a 180 eligibility period for taking the exam. Earliest date you can test is 7 days after graduation.

33. On Exam Day…. When you arrive at the Pearson VUE test center, you’ll be asked to present: – a current government-issued photo ID (i.e., driver’s license or passport) with your pre-printed name and signature. – a second current ID with your name pre-printed and signature. When you apply, please verify that your name as listed in NCCPA’s records is the same as on your ID. If they do not match when presented at the test center; you will not be allowed to test that day. You’ll be required to do a palm vein scanning and have your picture taken at the test center.

34. On Exam Day… No personal belongings are allowed in the testing room. You will have use of a locker for storing those items. – Brimmed hats, book bags, handbags, books, notes, study materials, calculators, watches of any kind, electronic paging devices, recording or filming devices, radios, cellular phones, or food and beverages, jackets) If you need to take a medical device in with you, you may have to apply for special accommodations when registering. – For more information, go to www.nccpa.net.ww.nccpa.net

35. On Exam Day… Test center staff will provide instructions on the use of the computer equipment. Then, you’ll have the opportunity to complete a brief tutorial. The examination will be managed and observed by test center staff with the aid of audio and video monitors and recording equipment.

36. On Exam Day… Clock-stopping breaks are not permitted once a test block begins. Take breaks between exam blocks, although keep in mind your total break time is limited to 45 minutes. Taking long or frequent breaks early in the day may leave you with no break time—even between blocks—later in the day. Each time you leave, you will be required to sign out and sign back in upon return. You must present your ID each time you sign in.

37. On Exam Day… You may answer the questions within a block in any order, and you may review and change responses within a block of questions during the time allotted for that section. After you exit a block of test questions or after time expires for that block, you won’t be allowed to review its questions or change your answers.

38. Scores NCCPA provides online score reports. When your scores have been processed (within two weeks after your test date), NCCPA will e-mail you instructions for accessing your score report on your secure online record. Each exam is scored on two independent computer systems to assure accuracy.

39. More About Taking PANCE…. Consider nutritional and other personal needs: – Avoid heavy meal within two hours of examination – A complex carbohydrate shake approximately 30 minutes before examination may be beneficial – Keeps snacks and food for lunch available (cannot take into room)

40. More About Taking PANCE…. Get proper rest! Your exam performance should reflect your knowledge base rather than physical and mental endurance! Lack of sleep may result in deterioration of normal cognitive and psychomotor function

41. More About Taking PANCE…. Your physical and environmental needs during the testing period should be considered: – Plan to arrive at least 30 minutes before your scheduled testing time. – Arriving early MAY allow you to select a computer terminal in an optimal location— choose one with fewer distractions – If you arrive late you may not be admitted, and you will have to forfeit your exam fee and reapply. – Temperature extremes may be possible so dress in layers that will allow you to be comfortable

42. More About Taking PANCE… Do not panic if you see a question you did not anticipate or prepare for. Read the question as is. Avoid over analysis or oversimplifying.

43. More About Taking PANCE… More Suggestions: – If you have never heard of the choice, it is probably not the correct answer. – Answer each question as you progress – Test center personnel are not allowed to answer, interpret or clarify test items—and anyway, they’re not medical professionals! – CHANGE AN ANSWER ONLY IF YOU ARE SURE YOU HAVE ANSWERED IT INCORRECTLY!

44. Once the Exam is Over Try not to worry about your performance. The test is over! Do not discuss the test with others. – Sharing exam questions with others constitutes “irregular behavior”— or cheating. It’s just not worth it.

45. Conclusion Remember, testing is a part of professional life. It is important to deal with it in a rational way through preparation, review, study, and practice. These suggestions plus your ability should help you obtain the score that is truly reflective of your ability.