Expert Panel Sets PAEA End of Curriculum™ Performance Standards for 2026
The PAEA End of Curriculum exam is a 300-question standardized assessment designed to evaluate a student’s medical knowledge as one component of their readiness for graduation. Since its launch in 2020, the exam has relied on performance standards that help programs interpret student readiness. With the current standards set in January 2022, an updated blueprint and evolving expectations for PA graduates prompted a comprehensive review to ensure the exam continues to reflect contemporary practice and maintains its psychometric rigor.
Standards are typically set initially and then maintained over time through the process of equating. However, standards should be revisited regularly to ensure they remain appropriate for the exam’s intended purpose. Standards should also be reassessed when exam content changes, including updates to the content blueprint. PAEA has released a new blueprint and content area list for the End of Curriculum exam. Those resources are available for your review now and will go live with new End of Curriculum forms published in April 2026.
Standard-Setting Panelists: Dedicated Volunteers
A valid standard-setting process begins with careful selection of panelists. The panel must have expertise in the content assessed by the exam and direct experience with PA education, both in terms of curriculum and PA student capabilities. Individuals on the panel bring this experience and expertise to bear in judging test items and determining the levels of exam performance indicative of the degree of general medical knowledge demonstrated by PA students nearing graduation.
PAEA staff identified and recruited a diverse panel of 31 PA educators to participate in the 2025 standard-setting study. When selecting participants, PAEA sought diversity in areas such as geographic region, tenure in PA education, program affiliation (public/private institutions, size of institution), and professional role. The 31 participants brought a broad range of perspectives to the process.
PAEA would like to thank all of those who volunteered numerous hours during this process. It was inspiring to see a group of experienced PA educators working together on this important task.
Methods
The expert panel used two recognized standard-setting methods — the Bookmark Method and a Compromise Method (known as the Hofstee Method) — to determine updated performance standards for the End of Curriculum exam.
Panelists followed a rigorous process to identify the knowledge and skills indicative of three distinct performance categories: Limited Medical Knowledge, Satisfactory Medical Knowledge, and Advanced Medical Knowledge. This shared conceptual framework ensured consistent application of the Bookmark and Hofstee methods and produced points on the score scale that meaningfully reflect differences in student performance.
Drs. Robbie Furter and Melinda Blazar, PAEA’s Chief Data Officer and Principal Psychometrician and Assessment Editor in Chief, respectively, presented the panel’s recommendations to the PAEA Board of Directors in October 2025. The Board reviewed the process to ensure adherence to best practices, confirmed that the recommended standards are psychometrically and legally defensible, and approved the updated categorial scores.
Results
The scaled score necessary to achieve Satisfactory Medical Knowledge was set at 1435, up from 1400. The scaled score needed to achieve Advanced Medical Knowledge was set at 1545, slightly lower than 1555. The scaled score national average was updated to reflect the average of PA students’ scores who took the exam between August 2023 to July 2025. The updated national average is 1519.
The score scale of 1200 to 1800 remains unchanged, allowing scores from previous years to be compared with scores in future results. Using scaled scores (as opposed to raw scores, such as number or percent of questions correct) preserves continuity and supports defensible interpretation across exam forms. What changed were the thresholds required to achieve Satisfactory Medical Knowledge and Advanced Medical Knowledge, and the national average.
Programs should expect a shift in the distribution of students’ scores beginning in April 2026. Because the threshold for Satisfactory Medical Knowledge has increased and the threshold for Advanced Medical Knowledge has decreased slightly, fewer students are likely to fall into the Satisfactory category compared with previous years.
Implementation Timeline
The new exam forms and categorical scores will go live in April 2026.
Guidance for Programs
PAEA provides both performance standards and national comparative data on the End of Curriculum exam score reports to support programs in evaluating students’ readiness for graduation. Programs must determine if these performance standards align with their local expectations and should continue to monitor individual and cohort performance. Regular review of exam outcomes allows programs to adjust their local scoring process to ensure alignment with curricular goals and evolving practice expectations.
