CAGEN
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Study Guide:
Upon entering the examining room, the candidate finds a "patient", two board examiners, and a trained video photographer, as well as all necessary examination tools. The 2009 ACNB Practical Examination will be case based. Each candidate will be given a description of symptoms. The candidate will be evaluated on his/her ability to obtain pertinent history on the presenting complaint/symptom as well as a complete and thorough general health history. The candidate will perform a thorough head-to-toe neurological/physical examination. The successful candidate will be able to derive a diagnosis and differential diagnoses as well as therapeutic meth odology for the case presentation. The history will draw out specifics for the presenting case symptoms but a complete health history will be expected in addition to the presenting complaint. The physical/neurological examination will follow the history. The time allotted for this portion of the practical examination is thirty (30) minutes. The history includes but is not limited to:
The candidate addresses all questions to the patient, speaking loudly enough to allow both the examiners and the camera to "hear" your questions and the answers. Each candidate is graded on the completeness of the history and the ability to ask questions that provide leads toward a diagnosis and uncover pertinent information. The candidate then performs a complete physical examination and is graded on the completeness of the examination and the accuracy in the psychomotor skills performed. The candidate states aloud what he/she is examining. For example: candidate performs the sensory pen wheel exam for trigeminal nerve and states "trigeminal nerve sensory test using pen wheel"; candidate performs popliteal reflex and states "popliteal reflex text of nerve root S1 using a reflex hammer at the patellar-tibia l (popliteal fossa) junction eliciting a reflex arc". It is advised that candidates conduct a comprehensive head-to-toe physical examination including but not limited to:
All physical examinations are performed on the patient to demonstrate the psychomotor skills involved.
Once that portion of the examination is completed, the candidate proceeds to a simulation examination where he/she is randomly assigned a set of video clips to view and respond to the questions regarding the findings. These clips will be of physical examination findings such as eye movements, gait, reflexes, blind spots, etc. At the conclusion of the clips, the candidate reviews the written notes may ask for one or more to be repeated. Only verbal answers will be scored. The written response is for the candidate's use in asking for a repeat only. Candidates will not take any materials away from the exam. This portion of the examination is allotted thirty (30) minutes (see Practical
Blueprint). The practical examination will include a five (5) to ten (10) minute question-answer session from the blueprint of neurological domains and objectives. The total time for the practical examination may approximate 1 1/2 hours.
In Conclusion:
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