End of Rotation™: Content

PAEA End of Rotation exams are a set of objective, standardized evaluations intended to serve as one measure of the medical knowledge students gain during specific supervised clinical practice experiences.

These resources are used by exam development board members to guide the creation of exam content, and by the exam development staff when constructing exam forms. They will be useful to students when studying for the exam, and for faculty when determining which other SCPE evaluation components and program objectives may require additional assessment tools.

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Questions on the exams are considered only a sample of all that might be included for the clinical experience and may not reflect all content identified in the topic lists.

Emergency MedicineBlueprintTopic List
Family MedicineBlueprintTopic List
General SurgeryBlueprintTopic List
Internal MedicineBlueprintTopic List
PediatricsBlueprintTopic List
Psychiatry & Behavioral HealthBlueprintTopic List
Women’s HealthBlueprintTopic List


The End of Rotation exam Topic Lists, Blueprints, and Core Tasks and Objectives are resources used by PAEA to guide the development of exam content and construction of exam forms. Questions on the exam are considered only a sample of all that might be included for the clinical experience, they are not intended to be all-inclusive, and may not reflect all content identified in the Topic Lists. These resources will be useful to faculty when determining which other supervised clinical education experience objectives may require additional assessment tools. These resources may also be useful to students when studying for the exam; however the Topic Lists are not a comprehensive list of all the exam question topics. PAEA’s goal is not to provide a list of all the topics that might be on the exams, but rather to provide students with a resource when preparing for the exams. PAEA recommends that students review the Topic List, Blueprint, and Core Tasks and Objectives in conjunction when preparing for the exam.

Guiding Principles

Several cross-cutting criteria guide the development and delivery of the End of Rotation exams. The goal of these ideals is to assist the exam development team in ensuring that the exams, to the extent a multiple-choice exam can, evaluate a wide breadth of dimensions critical to a PA student’s preparation. This list has evolved as the End of Rotation exam program has matured.

  • The End of Rotation exam blueprints are two-dimensional, meaning that they are organized by task and content area. Each End of Rotation exam is built to blueprint and topic list specifications. Questions encompass a representative sample of content topics and may not reflect all content topics identified in the topic lists.
  • Questions developed for End of Rotation exams reflect the needs of a broad diversity of patients whom PAs will treat.
  • Questions developed for End of Rotation exams cover the lifespan and reflect a variety of patient care settings with some specifications in the seven core areas:
    • Emergency Medicine
      • Full lifespan
      • Emergency department, urgent care
    • Family Medicine
      • Full lifespan
      • Ambulatory, urgent care, and long-term care
    • General Surgery
      • Full lifespan
      • Ambulatory, emergency department, inpatient, and perioperative
    • Internal Medicine
      • Adult and geriatric
      • Ambulatory, inpatient, and long-term care
    • Pediatrics
      • Infants, children, and adolescents
      • Ambulatory, emergency department, and inpatient
    • Psychiatry and Behavioral Health
      • Full lifespan
      • Ambulatory, emergency department, and inpatient
    • Women’s Health
      • Adolescent and adult
      • Ambulatory, emergency department, inpatient, and perioperative
  • Questions are geared toward a PA student who has completed the relevant supervised clinical practice experience.

  • Questions are typically presented in vignette format so that the exams can better assess students’ capacity for problem-solving and critical thinking.
  • Each End of Rotation exam consists of 120 multiple-choice questions, 100 of which are scored. The other 20 questions are unscored pretest questions used to gather statistics, which aid in future exam construction.
  • The End of Rotation exam contains two sections.
  • Each End of Rotation exam has at least two forms, providing the option for a re-test form should a student fail the first administration. Family medicine has three forms available for administration. This allows programs with two family medicine rotations to test twice with End of Rotation exams and still retain a third form for re-testing.

  • End of Rotation exams are intended to be used in conjunction with other evaluation modalities when assigning a student grade for a supervised clinical practice experience.
  • End of Rotation exams are delivered in PAEA’s secure, web-based platform, ExamDriver.
  • End of Rotation exams must be timed. The requirement for active proctoring has been waived. Programs that wish to do so may continue to monitor students via remote proctoring services or videoconference services. View the Proctor Resources page for information on monitoring options and best practices should your institution choose to proctor exams.
  • ExamDriver scheduling and administration procedures remain unchanged — programs still need to assign a proctor to start the exam at the appointed time. The system allows you to disable auto-pause and auto-end alerts that occur in the event of suspected inappropriate behavior. If these settings remain enabled, a proctor must provide rationale for auto-paused exams. The behavioral alerts (Viewing Other Content, Screen Capture Detected, and Inappropriate Key Stroke) are still captured in the exam activity and must be investigated. PAEA Assessment Exam Policies on student responsibilities in the Honor Code still aply.
  • Items are randomized for each student administration, within each section of the exam, and form assignments are randomized within each cohort to ensure exam security.
  • Scores are reported in a way that allows students and programs to see where students fall compared to other PA students taking the same standardized exam nationwide.

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