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Surviving the Clinical Skills Exam (CSE)


Poonam is a member of the Class of 2020. She’s been working in the Communications Office as an OD1 contributing to our social media and website. Below, she shares her experiences as a first year taking the Clinical Skills Exam.

As the semester comes to end, my first year class is looking forward to celebrating finishing our group projects and poster presentations. However, we have two more things to finish first – our clinical skills exams and finals.

Before we could even worry about finals, we began spending all our time practicing for the CSEs, or Clinical Skills Exams. This exam lets us show how much we’ve learned in clinical skills. This semester, we are being tested on retinoscopy, refraction, and near binocular testing, along with visual acuity and a random entrance test from last semester.

We’ve been practicing all semester to get ready for the CSEs. My friends and I were in pre-clinic the first day back from winter break when it was practically deserted. We practiced after class, we practiced in PPO lab, we practiced with upperclassmen, we practiced with classmates we never spoke to before, we practiced with lenses taped to phoropters, and we practiced in different bays.

Despite all the practicing, we were still nervous when it came time to take the CSE. We couldn’t predict who our patient would be, what their prescription was, which bay we would be in, which entrance test we would perform, or which preceptor was grading us. And that’s the point of the clinical skills exam – to simulate what clinic in real life might be like. It teaches us to stay calm, to think clearly, and to be prepared for any situation we are about to face.

However, like anything in life, it’s easier said than done. During the week of the CSEs, an anxious crowd of students waited outside of pre-clinic after class every day to sign up for one-hour slots to practice. The night before my CSE, I wrote up a script of everything I had to say and thought up all possible scenarios and how I would handle them. I was feeling pretty confident with my skills, but there’s something daunting about having a preceptor hover behind you and scribble down notes with every move you make and every sentence you speak. The thought of that made me more nervous.

The morning of my clinical skills exam, I arrived almost an hour early, waiting for my name to be called. While we were waiting, a professor stopped by and told us how they failed a section of their proficiencies when they were in school, but they still passed boards and graduated. It made all of us feel so much better. We were fretting over something that we could retake and something that didn’t define the rest of our careers.

As a show of support, I hugged my classmates upon entering the room before I went to set up my equipment in my bay. When the timer started, I remembered the words of an OD3 telling me trust my instincts and to not spend too much time thinking about something. It felt like everything went by so quickly, but also like the longest 25 minutes of my semester. I felt that I did well for the most part, but then started thinking about things I may have missed. Did my patient understand my directions? Did I forget to ask my patient certain questions? Did I answer all my preceptor’s questions correctly? Did I record the results accurately? I was desperately hoping that the little things wouldn’t add up and count against me.

Once I left the exam room, I ran into my favorite OD3, who assured me that even if I have to retake certain sections, it wasn’t the end of the world. I let out a sigh of relief when I heard that. I let out even a bigger sigh of relief when I got back my results and they were positive.

Everyone always gets so anxious when the CSEs are coming up, but once they’re over, it feels like they didn’t even happen. We go into lab the next week and start working on new techniques; we focus all our time on studying for finals; and we don’t think about it again until we have to take the next round of CSEs over the summer. The clinical skills exam makes students both nervous and excited because these are the skills we’ll be using in clinic during second year and beyond. It’s not important to us just because of the grade, but because we want to provide patients with the best experience during their visit.

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