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CPHQ Exam Preparation: The Problem With Advice

I had an “Aha!” moment during a telephone call with a client yesterday.

Here’s the background: the client had signed up for a CPHQ exam preparation workshop, and I wanted to learn more about her and her preparation for the exam. (I routinely review the workshop attendee lists as part of the preparations.) So I picked up the phone and called her.

In the middle of our conversation, she asked a question that made me pause for a second.

Her question related to how soon people are ready to sit the CPHQ exam after the workshop.

Sounds like an easy question, doesn’t it?

Not quite.

I was stumped not because I didn’t know the answer—the majority of candidates who attend my workshop and who go on to take the exam pass within 3 months—but because I had a choice of how to answer, i.e. giving a broad generalization or providing a detailed description of each person that I have ever taught. (I eventually chose something in between the two extremes, but nonetheless quite vague.) It’s also funny that I hadn’t experienced any problem answering identical or similar questions in the past.

Through my career, I have met a whole range of CPHQs and CPHQ candidates—no two of them are the same; they differ in terms of experience, training, intelligence, personality, motivation, nationality, career and economic circumstances, etc. In fact, this variety is one of the things that makes CPHQ training interesting.

The example above also highlights a problem formed by the confluence of three factors:

  1. Diversity of the candidate pool.
    As alluded to above, CPHQ candidates are heterogeneous in several determinants of CPHQ exam success.
  2. General questions.
    Examples of common questions are: “Should people read Janet Brown’s book only?”, “How long does it take to prepare for the CPHQ exam?”, “What can people do with CPHQ certification?” Such questions are seldom specific enough to be helpful to any particular individual. Consider this other general question: “Should everyone buy a new car?”
  3. The person from whom advice is sought knows “too much.”
    The less informed tend to make the most sweeping statements, often based on their own experience and not that of the person seeking advice. In this scenario, there is almost always no conflict. On the other hand, an individual with lots of knowledge and experience, plus a genuine desire to put the needs of the candidate first, is more likely to give a balanced perspective that considers all the available information. Sadly, the latter is rare in the realm of CPHQ exam preparation.

Advice Is Cheap

When I first started my consulting business, I asked some people for advice on how to succeed in business. It seemed like a reasonable thing to do. You would have thought that people with more experience than me would be able to offer useful tips, suggest growth opportunities, and point out potential pitfalls to avoid.

Well, I had no shortage of advice, suggestions, recommendations, ideas, etc. Some were probably helpful but I could have done without most of them.

Conceptually, the issues associated with the advice I received for my business are no different to those related to information fed to CPHQ candidates.

Allow me to elaborate.

One problem with asking for advice is that it is too easy. Anyone can do it. And because anyone can do it, everyone does it.

Also, when people ask for advice, there is usually plenty of it in return. It’s not difficult at all to give a brief answer to a “simple question,” and since it is so simple to do, the overall quality of the advice being given is typically quite low.

Many people, when dispensing advice, throw out the first thing that comes to mind. The advice given about a certain topic one day might be completely different to that the next day. Example: “What’s the best way to prepare for the CPHQ exam?” Today the answer might be, “Study Janet Brown’s book.” The answer from the same person tomorrow or even at a later part of the same day may be, “Do more practice test questions from XYZ.”

Why does this variability occur? The advice you get depends on a lot of factors, including the person’s state of mind, what’s going on in their professional and private life, the pressures of the moment, etc. This is a normal phenomenon, and there’s nothing wrong with it per se. But it helps to be aware of it.

It also means that you should not place too much weight on the advice of one person, even if he/she is someone you respect and admire. To use the analogy of scientific evidence, it is never wise to draw your conclusion from the findings of one case report. In fact, it is imprudent to rely on a case series. Yet, people make decisions based on advice, recommendations, and suggestions of a relatively small set of opinions everyday!

Irrelevant Advice

Often advice is given by people who see things through their own lens and, as such, their answers might be totally irrelevant to your own set of circumstances.

For example, in the early days of my business, people were telling me to go out and do more marketing because that was the only way they knew how to draw more clients. But this approach didn’t fit my style; I felt uncomfortable and the results were average. It wasn’t long before I decided on a different tack—one based on delivering value and measurable results. Since then, the firm has enjoyed quite satisfactory growth, largely from word-of-mouth advertising (which of course also significantly reduces the cost of marketing and promotional activities).

As another example, one person’s advice to focus on the Performance Measurement and Improvement section of the exam’s content outline might be pertinent to the advice giver’s set of circumstances but not to that of another person who is extremely adept in the area of performance measurement and performance improvement.

Outdated Advice

Another problem with seeking advice is the possibility that it is outdated.

When you ask for advice, chances are you’re going to hear suggestions based on what worked in the past. The same advice might not help in the future.

For instance, what might be good advice for CPHQ exam preparation 10 years ago is unlikely to be applicable now. Why? A lot of things have changed in the last decade, e.g. the exam format, the exam content, the available resources, learning methods, etc.

In the last few years alone, we have witnessed a lot of changes in healthcare quality management and in information technology and management. Yet, many individuals—and organizations—seem to think that old world solutions can still effectively address the problems of today. The reality is that we need to progress with the times. Healthcare quality practice will increasingly be grounded in science (and not opinion), pen and paper will be replaced by the iPad, and PowerPoint is so passé compared to the likes of Apple Keynote and Prezi.

The advice you get about your CPHQ exam preparation is only useful if it is based on current conditions.

An Advice Giver’s Perspective

Among CPHQ candidates, the commonest question I’m asked (by far) is: “What’s the best way of passing the CPHQ exam?”

Unless I’ve spent plenty of time with you (as I do with my private clients), the straight and honest answer is, “I don’t know.” But that doesn’t usually satisfy anyone. So I usually have to go on to explain how I need to understand the person’s situation, experience, qualifications, strengths, weaknesses, etc. I invest a lot of time talking with my clients before formulating a plan that is both valuable and actionable, i.e. one which will lead to the person achieving CPHQ status in the quickest time possible and with the least amount of effort (or pain). Needless to say, I cannot provide this service for free—I still have a busy healthcare consulting firm to run!

Ask the Right Question

People looking for tips on how to approach the exam actually mean to ask this question: “What’s the best way for me to pass the CPHQ exam?”

This is a more specific question because it is focused on one person—you. But it automatically entails a long and tedious description of your background, personality, preferred learning style, available resources and a host of other factors. In my experience most candidates are not prepared for this exercise, for a variety of reasons including time and financial constraints, as well as a lack of commitment.

To recap, there are probably only three factors that, when combined, create a problem in providing advice about CPHQ exam preparation:

  1. Heterogeneity of the candidate pool
  2. General questions
  3. Wealth of experience of the advice giver

The first and third factors are beyond anyone’s control. However, the way in which questions are framed is definitely within the control of the person seeking answers. By providing the relevant information, and perhaps making the necessary investment in time, you will probably get a satisfactory answer that is tailored to your needs and circumstances. There might still be an element of prejudice and bias in any recommendation or suggestion but this risk is considerably lessened if the person dispensing the advice is given all the pertinent information. The advice giver also gets an implied message that you want a balanced, objective response and not one that he/she thinks you want to hear.

People looking for advice often also have their own set of preconceived ideas and beliefs and are merely searching for reinforcement of their previously held notions. By laying all the cards on the table, the person has an opportunity to examine his or her own preconceptions against the facts.


Obtaining advice from the average person—CPHQ or otherwise—about preparing for the CPHQ exam is likely to be problematic due to a number of factors.

You might have wondered why I haven’t shared the questions I asked about the CPHQ exam before I took it.

I knew quite a number of CPHQs before I took the exam but I did not ask them any question about the exam mainly because of geographical distance. That doesn’t mean I had no question; I had plenty! Without anyone else in the country who had attempted the exam, let alone pass it, I could not speak with and request advice from anyone face-to-face.

That was probably a blessing in disguise.

I devised my own method of preparing for the exam, which involved some novel approaches and techniques. In total, I read only about half of Janet Brown’s The Healthcare Quality Handbook; even that amount was probably too much for the exam in retrospect. I created my own practice exam questions. I did not purchase any questions or “study guides” that were on the market, mainly because I was suspicious about their quality (as I still am). I certainly did not need to learn generic “secrets” to taking the CPHQ exam because I was already by then a seasoned test taker; I view generic exam taking tips (packaged as CPHQ “study guides”) akin to telling me that I need to eat more vegetables and less animal fat, to exercise regularly, and to avoid cigarette smoking—banal stuff.

Instead, I developed my own CPHQ exam-specific “secrets,” which I later used to help tens of individuals realize their dream of becoming a CPHQ.

My CPHQ exam result was not a borderline pass either—out of the 125 scored questions on the exam, I answered 113 correctly. That’s more than 90%, or nine out of every 10, questions answered correctly. And I completed the exam (comfortably) with more than an hour to spare. Not bad.

I got zero advice about the CPHQ exam and CPHQ exam preparation. No LinkedIn or Facebook groups.

So much for the value of “advice.”

My story may not apply to all candidates because most others are not likely to share my training, professional experience, and scholarship.

However, it does prove a point: By using your creative energies, you can come up with your own answers. You may feel the need to prod around for ideas but I’m confident you will benefit from thinking independently and harnessing your intrinsic problem-solving skills. The solution that you develop for yourself is probably going to be the best.

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