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Background: The Mini-Clinical Evaluation Exercise (Mini-CEX) is a valuable formative assessment tool in medical education. It involves direct observation of a student's clinical skills by a faculty member, followed by immediate constructive feedback. There is limited data available on the utility of Mini-CEX for undergraduate assessment. The aim of this study was to compare the effectiveness and reception of Mini-CEX and traditional practical assessments in Pediatrics among medical students and faculty members. Materials and Methods: This prospective educational comparative study was conducted over six months, from April 2021 to September 2021, involving undergraduate medical students of Phase-3, Part-2. The students were randomly divided into four groups (A, B, C, and D). In the first encounter, two groups participated in a traditional practical examination, while the other two groups underwent a Mini-Clinical Evaluation Exercise (Mini-CEX) assessment. For the second encounter, the assessment methods were swapped between the two groups. Systematic feedback was provided to each student following the Mini-CEX assessment. Additionally, feedback was collected from both, students and faculty members, regarding their experiences and opinions on the assessment methods. Results: This study found that Mini-CEX scores were significantly higher than TPE scores (P=0.006489). There was also significant inter-examiner variability in Mini-CEX marks (p < 0.00001). Both students and faculty members provided positive feedback regarding the Mini-CEX. Despite its benefits, the time required to conduct the examination is a major limitation for undergraduate assessment. Conclusions: Mini-CEX is a valuable tool in undergraduate medical education for assessing and improving clinical skills. By providing structured, real-time feedback, it helps students develop into competent and confident clinicians. The time required to conduct the examination is a major limitation for undergraduate assessment.

Background: Assessment is a key feature of teaching and the curriculum. It has a massive impact on the quality of learning. It is observed that at the postgraduate level, 80% of trainees are not observed, and the remaining were observed not more than once in their three years programme. Current assessment of postgraduate students is at the end of three years. It predominantly assesses the cognitive part and no scope to improve their clinical skills. In view of it, this study was planned to conduct formative assessment for postgraduate students with the help of Mini-CEX and DOPS and to seek their perception. Methods: The postgraduate students of Department of Kayachikitsa and Panchakarma were invited voluntarily. Total 24 students (including first, second, and third year) were sensitized about the procedure of Mini-CEX and DOPS. The “encounters” were planned and schedule was displayed with names of student and teacher. The type of case was decided together by teacher and student. Each student was exposed to two Mini-CEX and two DOPS). Specific systemic examination and procedures were selected for Mini-CEX and DOPS, respectively. The time allocated for Mini-CEX and DOPS was as per the type of procedure but usually 15 minutes was allotted to each encounter for observation. Result: Overall students’ feedback about formative assessment was positive helping them to identify the gaps in their knowledge, and motivating them to learn. Conclusion: Mini-CEX and DOPS were well accepted by students as well as faculties as a formative assessment tool.

ABSTRACT: Background: Assessment is a key feature of teaching and the curriculum. It has a massive impact on the quality of learning. It is observed that at the postgraduate level, 80% of trainees are not observed, and the remaining were observed not more than once in their three years programme. Current assessment of postgraduate students is at the end of three years. It predominantly assesses the cognitive part and no scope to improve their clinical skills. In view of it, this study was planned to conduct formative assessment for postgraduate students with the help of Mini-CEX and DOPS and to seek their perception. Methods: The postgraduate students of Department of Kayachikitsa and Panchakarma were invited voluntarily. Total 24 students (including first, second, and third year) were sensitized about the procedure of Mini-CEX and DOPS. The "encounters" were planned and schedule was displayed with names of student and teacher. The type of case was decided together by teacher and student. Each student was exposed to two Mini-CEX and two DOPS). Specific systemic examination and procedures were selected for Mini-CEX and DOPS, respectively. The time allocated for Mini-CEX and DOPS was as per the type of procedure but usually 15 minutes was allotted to each encounter for observation. Result: Overall students' feedback about formative assessment was positive helping them to identify the gaps in their knowledge, and motivating them to learn. Conclusion: Mini-CEX and DOPS were well accepted by students as well as faculties as a formative assessment tool. [ABSTRACT FROM AUTHOR]

Abstract Objective To explore the application effect of mini clinical evaluation exercise (Mini-CEX) combined with direct observation of procedural skills (DOPS) in the standardized training of general practitioners in community clinics. Methods From June 2022 to June 2023,20 general practitioners who received standardized training for residents in the general outpatient department of Changqing Community Health Service Center of Wuhan Fourth Hospital were collected as the research objects. Mini-CEX combined with DOPS was used to evaluate the general practitioners at the time of admission, 2 weeks of training and 4 weeks of training, and the results were fed back. Results The scores of 20 general practitioners at 2 weeks and 4 weeks of training were compared with the scores at the time of admission, and the difference was statistically significant, p

OBJECTIVE: To compare pre- and post-mean scores of Mini-Clinical Evaluation Exercise (Mini-CEX) and Direct Observation of Procedural Skills (DOPS), and to assess supervisor and student satisfaction with Mini-CEX and DOPS over time among final year medical undergraduates. METHODS: This study was conducted on 90 final year medical students at a Private Medical College in Karachi from May 2022 to November 2022. Pre- and post-testing involved Objective Structured Clinical Examination before and after the last session of DOPS and Mini-CEX, comprising six stations. Workshops on Mini-CEX and DOPS were conducted for supervisors and students before pre-testing. Core clinical competencies included history taking, physical examination, counselling skills, critical thinking, professionalism, organization, management skills, and overall clinical performance. Data was analysed through SPSS version-23. RESULTS: Over six months, 1080 encounters were conducted among 90 students in six sessions. Mean pre-test score for Mini-CEX was 13.78±3.61 and for DOPS was 11.57±3.0, with post-test scores of 43.61±3.38 and 42.28±1.8, respectively (p-value

Resumen: Introducción: a pesar de los avances en el aprendizaje tradicional, no se han demostrado cambios en el comportamiento del alumno. Con la simulación, se desarrollan herramientas que mejoran las actitudes y el desempeño de las competencias médicas. Métodos: estudio prospectivo y descriptivo que evalúa las competencias médicas de 81 estudiantes de Medicina a través del mini-Clinical Evaluation Exercise (mini-CEX), técnica de evaluación por observación directa compuesta por 7 dominios. Cada estudiante realiza 3 mini-CEX: al principio del curso, antes de realizar tanto la simulación (SIM) como la práctica clínica (PC) (etapa 1); en la mitad, tras realizar solo uno de los 2 (etapa 2 tras SIM, etapa 2 tras PC); y al final del curso, tras ambos (etapa 3). Resultados: la puntuación media fue de 2,7 en el primer mini-CEX; 6,2 en el segundo tras SIM, 2,5 en el segundo tras PC; y 7,2 en el último. El 29,6% realizaron de forma satisfactoria/superior la etapa 1, el 96,3% la etapa 2 tras SIM, el 25,8% la etapa 2 tras PC y el 97,4% la etapa 3.Cuando realizaron primero PC a lo largo del curso la evaluación media fue de 2,6 en el primer mini-CEX, 2,5 en el segundo y 6,4 en el último. Tras realizar primero SIM fue de 2,8; 6,2 y 7,6; respectivamente. Conclusiones: la simulación permite una mejoría notable de las competencias médicas. Los estudiantes desarrollan herramientas mediante la simulación, que al aplicarlas a la práctica clínica real aún consiguen un mayor impacto en estas competencias médicas. Abstract: Introduction: Despite advances in traditional learning, we don't demonstrate changes in student's behavior. With simulation, students develop tools that improve attitudes and performance of medical competencies. Methods: This prospective and descriptive study evaluated the medical competencies of 81 medical students by conducting a mini-clinical evaluation exercise (mini-CEX), direct observation evaluation technique composed of 7 domains. All students perform 3 mini-CEX: at the beginning of the course before performing either simulation (SIM) or clinical practice (PC), in the middle of the course after performing simulation or clinical practice, and at the end of the course after performing both. Results: The average ratings were 2.7 in mini-CEX stage 1, 6.2 in stage 2 after SIM, and 2.5 in stage 2 after PC, and 7.2 in stage 3 after both SIM and PC. Approximately 29.6% of students passed the assessment satisfactorily or better in stage 1, 96.3% in stage 2 after SIM, 25.8% in stage 2 after PC, and 97.4% in stage 3.Students who initially performed PC throughout the course had average assessment rates of 2.6 in mini-CEX stage 1, 2.5 in stage 2, and 6.4 in stage 3. Students who initially performed SIM, had average assessment rates of 2.8, 6.2 and 7.6 in stage 1, 2, and 3, respectively. Conclusions: Simulation allows a significant improvement in medical skills. Students develop tools through simulation, that applied to real clinical practice achieve an even greater impact on these medical competencies.

Objective: To explore the application effect of mini clinical evaluation exercise (Mini-CEX) combined with direct observation of procedural skills (DOPS) in the standardized training of general practitioners in community clinics. Methods: From June 2022 to June 2023,20 general practitioners who received standardized training for residents in the general outpatient department of Changqing Community Health Service Center of Wuhan Fourth Hospital were collected as the research objects. Mini-CEX combined with DOPS was used to evaluate the general practitioners at the time of admission, 2 weeks of training and 4 weeks of training, and the results were fed back. Results: The scores of 20 general practitioners at 2 weeks and 4 weeks of training were compared with the scores at the time of admission, and the difference was statistically significant, p < 0.05. Conclusion: Mini-CEX combined with DOPS can improve the teaching effect of standardized training of residents in community general clinics. [ABSTRACT FROM AUTHOR]

Abstract Background As an important medical personnel training system in China, standardized residency training plays an important role in enriching residents’ clinical experience, improving their ability to communicate with patients and their clinical expertise. The difficulty of teaching neurology lies in the fact that there are many types of diseases, complicated conditions, and strong specialisation, which puts higher requirements on residents’ independent learning ability, the cultivation of critical thinking, and the learning effect. Based on the concept of ADDIE (Analysis-Design-Development-Implementation-Evaluation), this study combines the theory and clinical practice of flipped classroom teaching method to evaluate the teaching effect, so as to provide a basis and reference for the implementation of flipped classroom in the future of neurology residency training teaching. Methods The participants of the study were 90 neurology residents in standardised training in our hospital in the classes of 2019 and 2020. A total of 90 residents were divided into a control group and an observation group of 45 cases each using the random number table method. The control group used traditional teaching methods, including problem based learning (PBL), case-based learning (CBL), and lecture-based learning (LBL). The observation group adopted the flipped classroom teaching method based on the ADDIE teaching concept. A unified assessment of the learning outcomes of the residents was conducted before they left the department in the fourth week, including the assessment of theoretical and skill knowledge, the assessment of independent learning ability, the assessment of critical thinking ability, and the assessment of clinical practice ability. Finally, the overall quality of teaching was assessed. Results The theoretical and clinical skills assessment scores achieved by the observation group were significantly higher than those of the control group, and the results were statistically significant (P

Background: As an important medical personnel training system in China, standardized residency training plays an important role in enriching residents' clinical experience, improving their ability to communicate with patients and their clinical expertise. The difficulty of teaching neurology lies in the fact that there are many types of diseases, complicated conditions, and strong specialisation, which puts higher requirements on residents' independent learning ability, the cultivation of critical thinking, and the learning effect. Based on the concept of ADDIE (Analysis-Design-Development-Implementation-Evaluation), this study combines the theory and clinical practice of flipped classroom teaching method to evaluate the teaching effect, so as to provide a basis and reference for the implementation of flipped classroom in the future of neurology residency training teaching. Methods: The participants of the study were 90 neurology residents in standardised training in our hospital in the classes of 2019 and 2020. A total of 90 residents were divided into a control group and an observation group of 45 cases each using the random number table method. The control group used traditional teaching methods, including problem based learning (PBL), case-based learning (CBL), and lecture-based learning (LBL). The observation group adopted the flipped classroom teaching method based on the ADDIE teaching concept. A unified assessment of the learning outcomes of the residents was conducted before they left the department in the fourth week, including the assessment of theoretical and skill knowledge, the assessment of independent learning ability, the assessment of critical thinking ability, and the assessment of clinical practice ability. Finally, the overall quality of teaching was assessed. Results: The theoretical and clinical skills assessment scores achieved by the observation group were significantly higher than those of the control group, and the results were statistically significant (P < 0.001). The scores of independent learning ability and critical thinking ability of the observation group were better than those of the control group, showing statistically significant differences (P < 0.001). The observation group was better than the control group in all indicators in terms of Mini-Cex score (P < 0.05). In addition, the observation group had better teaching quality compared to the control group (P < 0.001). Conclusion: Based on the concept of ADDIE combined with flipped classroom teaching method can effectively improve the teaching effect of standardized training of neurology residents, and had a positive effect on the improvement of residents' autonomous learning ability, critical thinking ability, theoretical knowledge and clinical comprehensive ability. [ABSTRACT FROM AUTHOR]

Introduction: The mini-Clinical Evaluation Exercise (CEX) is meant to provide on the spot feedback to trainees. We hypothesised that an ultra-short assessment tool with just one global entrustment scale (micro-CEX) would encourage faculty to provide better feedback compared to the traditional multiple domain mini-CEX. Methods: 59 pairs of faculty and trainees from internal medicine completed both the 7-item mini-CEX and a micro-CEX and were surveyed regarding their perceptions of the 2 forms. Wordcount and specificity of the feedback was assessed. Participants were subsequently interviewed to elicit their views on factors affecting the utility of the CEX. Results: Quantity and quality of feedback increased with the micro-CEX compared to the mini-CEX. Wordcount increased from 9.5 to 17.5 words, and specificity increased from 1.6 to 2.3 on a 4-point scale, p < 0.05 in both cases. Faculty and residents both felt the micro-CEX provided better assessment and feedback. The micro-CEX, but not the mini-CEX, was able to discriminate between residents in different years of training. The mini-CEX showed a strong halo effect between different domains of scoring. In interviews, ease of administration, immediacy of assessment, clarity of purpose, structuring of desired feedback, assessor-trainee pairing and alignment with trainee learning goals were identified as important features to optimize utility of the (mini or micro or both) CEX. Conclusions: Simplifying the assessment component of the CEX frees faculty to concentrate on feedback and this improves both quantity and quality of feedback. How the form is administered on the ground impacts its practical utility.

Evaluation is a systematic process that results in a judgment to make decisions. The instruments used to obtain data on student performance require a systematic and objective process for their implementation. The mini-CEX is a direct observation tool that has been used for the evaluation of clinical competence in undergraduate and postgraduate students since its invention in 1955. It has different validity evidence for use in different educational and clinical contexts. It allows rapid evaluations, accompanied by feedback and providing relevant information on the development of clinical competence. The objective of this paper is to expose the experience of the implementation of the mini-CEX in the medical undergraduate for the formative evaluation of students using simulation with standardized patients. To achieve this goal, the following sequence was used: search, planning, integration, and application. After these steps we make some recommendations for the implementation of the mini-CEX. Its is concluded that the evaluation of clinical competence is important for the continuous and permanent improvement of undergraduate and graduate students. It is necessary to systematize the evaluation always adjusted to objectives and specific needs of the evaluation. [ABSTRACT FROM AUTHOR]

Resumen: Introducción: el Mini-Clinical Evaluation Exercise es una herramienta educativa que permite la evaluación de diversas competencias clínicas y escenarios de trabajo. El estudio tuvo el objetivo de analizar las características bibliométricas y el impacto de la producción científica Mini-Clinical Evaluation Exercise en áreas de las ciencias de la salud. Métodos: estudio bibliométrico cuya fuente de búsqueda fue Scopus. La consulta se realizó el 08 de mayo de 2023, considerando una estrategia de búsqueda conformada por operadores booleanos y términos clave. Para la estimación y visualización de los parámetros bibliométricos se utilizó la herramienta SciVal y el módulo Bibliometrix de RStudio. Resultados: Weller y Chen fueron los autores representativos y mostraron conexiones de divulgación con los principales países (Australia y China). La revista Education for Primary Care (Q2) fue la más productiva. Entre las subcategorías, General Medicine (34 publicaciones) y Anesthesiology and Pain Medicine (21,1 citas por publicación) tuvieron más publicaciones y mayor impacto, respectivamente. La mayoría de los manuscritos están publicados en revistas del cuartil Q3 (30,9%), seguido del cuartil Q1 (25,5%); además, en el periodo 2017 a 2021 hubo un aumento de las publicaciones (50 artículos). Las publicaciones con institucional fueron las más frecuentes, pero aquellos con colaboración internacional tenían más citas por publicación. Conclusiones: en los 5 últimos años existe un aumento en el número de investigaciones publicadas sobre Mini-Clinical Evaluation Exercise, y la revista principal para la divulgación fue Education for Primary Care. La colaboración nacional e institucional fueron las más frecuentes; además, Australia, China y Estados Unidos lideraron la actividad científica en este campo. Abstract: Introduction: The Mini Clinical Evaluation Exercise is an educational tool that allows the evaluation of various clinical competencies and work scenarios. The aim of this study was to analyze the bibliometric characteristics and impact of the scientific production of Mini-Clinical Evaluation Exercise (mini-CEX) in the health sciences. Methods: Bibliometric study whose search source was Scopus, the query was performed on May 8, 2023, considering a search strategy consisting of Boolean operators and key terms. The SciVal tool and the RStudio Bibliometrix module were used to estimate and visualize the bibliometric parameters. Results: Weller and Chen were representative authors and showed dissemination connections with the main countries (Australia and China). The journal Education for Primary Care (Q2) was the most productive. Among the subcategories, General Medicine (34 publications) and Anaesthesiology and Pain Medicine (21.1 citations per publication) had more publications and higher impact, respectively. Most manuscripts are published in Q3 quartile journals (30.9%), followed by Q1 quartile (25.5%); moreover, in the period 2017 to 2021 there was an increase in publications (50 articles). Publications with institutional were more frequent, but those with international collaboration had more citations per publication. Conclusions: In the last five years there is an increase in the number of published research on mini-CEX, and the main journal for dissemination was Education for Primary Care. National and institutional collaboration were the most frequent; in addition, Australia, China and the United States led the scientific activity in this field.

Abstract Background After the COVID-19 epidemic, the state has paid more attention to the clinical teaching function of affiliated hospitals of colleges and universities. Strengthening the integration of medicine and education and improving the quality and effect of clinical practice teaching are critical challenges facing medical education. The difficulty of orthopedic teaching lies in the characteristics of a wide variety of diseases, strong professionalism, and relatively abstract characteristics, which affect the initiative, enthusiasm, and learning effect of nursing students. In this study, a flipped classroom teaching plan based on the CDIO (conceive–design–implement–operate) concept was constructed and practiced in the orthopedic nursing student training course to improve the effect of practical teaching, and it is convenient for teachers to implement more effective and targeted teaching in the flipped classroom of nursing education and even medical education in the future. Methods Fifty undergraduate nursing students who practiced in the Orthopedics Department of a tertiary hospital in June 2017 were enrolled in the control group, while 50 undergraduate nursing students who practiced in the same department in June 2018 were enrolled in the intervention group. The intervention group adopted the flipped classroom teaching mode of the CDIO concept, whereas the control group adopted the traditional teaching mode. After finishing the department practice task, the students in the two groups completed the evaluation of theory, operation skills, independent learning ability, and critical thinking ability. They completed the evaluation of clinical practice ability in eight dimensions, including four processes of nursing procedures, humanistic care ability, and evaluation of clinical teaching quality for two groups of teachers. Results After teaching, the clinical practice ability, critical thinking ability, autonomous learning ability, theoretical and operational performance, and evaluation of clinical teaching quality in the intervention group were significantly higher than those in the control group (all p

Abstract Background To investigate whether speech recognition software for generating interview transcripts can provide more specific and precise feedback for evaluating medical interviews. Methods The effects of the two feedback methods on student performance in medical interviews were compared using a prospective observational trial. Seventy-nine medical students in a clinical clerkship were assigned to receive either speech-recognition feedback (n = 39; SRS feedback group) or voice-recording feedback (n = 40; IC recorder feedback group). All students’ medical interviewing skills during mock patient encounters were assessed twice, first using a mini-clinical evaluation exercise (mini-CEX) and then a checklist. Medical students then made the most appropriate diagnoses based on medical interviews. The diagnostic accuracy, mini-CEX, and checklist scores of the two groups were compared. Results According to the study results, the mean diagnostic accuracy rate (SRS feedback group:1st mock 51.3%, 2nd mock 89.7%; IC recorder feedback group, 57.5%–67.5%; F(1, 77) = 4.0; p = 0.049), mini-CEX scores for overall clinical competence (SRS feedback group: 1st mock 5.2 ± 1.1, 2nd mock 7.4 ± 0.9; IC recorder feedback group: 1st mock 5.6 ± 1.4, 2nd mock 6.1 ± 1.2; F(1, 77) = 35.7; p

Context: Workplace-based assessment (WPBA) is an essential component of competency-based assessment addressing the “does” level. The study was planned to understand the perceptions and experiences of medical faculties with WPBA for its formal adoption under CBME. Aim: To obtain faculty perceptions and their experiences with WPBA as a medical educator. Settings and Design: A cross-sectional survey was conducted as a part of an online web discussion on WPBA among 38 faculties. Materials and Methods: The information was collected through an online semi-structured questionnaire and data were analyzed using percentages, proportions, and themes. Results: The majority were 31–50 years, females and professors. Directly observed procedural skills (DOPS), case-based discussion (CBD), and logbooks were commonly used tools. The challenges in WPBA practice were hesitancy, time constraints, lack of resources, complexity of tools, and pandemic situation. Conclusions: practice of WPBA tools was perceived positively, however a huge gap was noticed between knowledge and practice of WPBA tools.

Abstract Objective Mini clinical evaluation exercise (mini-CEX) and objective structured clinical examination (OSCE) are widely acknowledged as effective measures of resident standardization training (RST) in European and American countries. However, in China primary mini-CEX and OSCE forms are mainly limited in undergraduate clinical examination. Little knowledge is available regarding the validity and right way of mini-CEX /OSCE evaluation system in advanced dental clinical education so far. This study aimed to explore whether combination of mini-CEX and OSCE represents a global-dimension assessment for postgraduate clinical competence in RST. Methods Postgraduates who received RST from June 2017 to June 2019 were selected and evaluated by modified mini-CEX/OSCE scales. Each student received evaluations at least twice in the initial and final stages of training (tested every 4 months). A questionnaire was conducted to investigate the satisfaction with the arrangement of RST. Results Mini-CEX/OSCE test results indicated that postgraduates have significantly improved their comprehensive competence in RST projects in the department of prosthodontics (P

Clinical workplace-based learning is essential for undergraduate health professions, requiring adequate training and timely feedback. While the Mini-CEX is a well-known tool for workplace-based learning, its written paper assessment can be cumbersome in a clinical setting. We conducted a utility analysis to assess the effectiveness of an adapted Mini-CEX implemented as a mobile device WebApp for clinical practice assessment. We included 24 clinical teachers from 11 different clinical placements and 95 undergraduate physical therapy students. The adapted Mini-CEX was tailored to align with the learning outcomes of clinical practice requirements and made accessible through a WebApp for mobile devices. To ensure the validity of the content, we conducted a Delphi panel. Throughout the semester, the students were assessed four times while interacting with patients. We evaluated the utility of the adapted Mini-CEX based on validity, reliability, acceptability, cost, and educational impact. We performed factor analysis and assessed the psychometric properties of the adapted tool. Additionally, we conducted two focus groups and analyzed the themes from the discussions to explore acceptability and educational impact. The adapted Mini-CEX consisted of eight validated items. Our analysis revealed that the tool was unidimensional and exhibited acceptable reliability (0.78). The focus groups highlighted two main themes: improving learning assessment and the perceived impact on learning. Overall, the eight-item Mini-CEX WebApp proved to be a valid, acceptable, and reliable instrument for clinical practice assessment in workplace-based learning settings for undergraduate physiotherapy students. We anticipate that our adapted Mini-CEX WebApp can be easily implemented across various clinical courses and disciplines.

Background: To investigate whether speech recognition software for generating interview transcripts can provide more specific and precise feedback for evaluating medical interviews. Methods: The effects of the two feedback methods on student performance in medical interviews were compared using a prospective observational trial. Seventy-nine medical students in a clinical clerkship were assigned to receive either speech-recognition feedback (n = 39; SRS feedback group) or voice-recording feedback (n = 40; IC recorder feedback group). All students' medical interviewing skills during mock patient encounters were assessed twice, first using a mini-clinical evaluation exercise (mini-CEX) and then a checklist. Medical students then made the most appropriate diagnoses based on medical interviews. The diagnostic accuracy, mini-CEX, and checklist scores of the two groups were compared. Results: According to the study results, the mean diagnostic accuracy rate (SRS feedback group:1st mock 51.3%, 2nd mock 89.7%; IC recorder feedback group, 57.5%–67.5%; F(1, 77) = 4.0; p = 0.049), mini-CEX scores for overall clinical competence (SRS feedback group: 1st mock 5.2 ± 1.1, 2nd mock 7.4 ± 0.9; IC recorder feedback group: 1st mock 5.6 ± 1.4, 2nd mock 6.1 ± 1.2; F(1, 77) = 35.7; p < 0.001), and checklist scores for clinical performance (SRS feedback group: 1st mock 12.2 ± 2.4, 2nd mock 16.1 ± 1.7; IC recorder feedback group: 1st mock 13.1 ± 2.5, 2nd mock 13.8 ± 2.6; F(1, 77) = 26.1; p < 0.001) were higher with speech recognition-based feedback. Conclusions: Speech-recognition-based feedback leads to higher diagnostic accuracy rates and higher mini-CEX and checklist scores. Trial registration: This study was registered in the Japan Registry of Clinical Trials on June 14, 2022. Due to our misunderstanding of the trial registration requirements, we registered the trial retrospectively. This study was registered in the Japan Registry of Clinical Trials on 7/7/2022 (Clinical trial registration number: jRCT1030220188). [ABSTRACT FROM AUTHOR]

Background: After the COVID-19 epidemic, the state has paid more attention to the clinical teaching function of affiliated hospitals of colleges and universities. Strengthening the integration of medicine and education and improving the quality and effect of clinical practice teaching are critical challenges facing medical education. The difficulty of orthopedic teaching lies in the characteristics of a wide variety of diseases, strong professionalism, and relatively abstract characteristics, which affect the initiative, enthusiasm, and learning effect of nursing students. In this study, a flipped classroom teaching plan based on the CDIO (conceive–design–implement–operate) concept was constructed and practiced in the orthopedic nursing student training course to improve the effect of practical teaching, and it is convenient for teachers to implement more effective and targeted teaching in the flipped classroom of nursing education and even medical education in the future. Methods: Fifty undergraduate nursing students who practiced in the Orthopedics Department of a tertiary hospital in June 2017 were enrolled in the control group, while 50 undergraduate nursing students who practiced in the same department in June 2018 were enrolled in the intervention group. The intervention group adopted the flipped classroom teaching mode of the CDIO concept, whereas the control group adopted the traditional teaching mode. After finishing the department practice task, the students in the two groups completed the evaluation of theory, operation skills, independent learning ability, and critical thinking ability. They completed the evaluation of clinical practice ability in eight dimensions, including four processes of nursing procedures, humanistic care ability, and evaluation of clinical teaching quality for two groups of teachers. Results: After teaching, the clinical practice ability, critical thinking ability, autonomous learning ability, theoretical and operational performance, and evaluation of clinical teaching quality in the intervention group were significantly higher than those in the control group (all p < 0.05). Conclusion: The CDIO-based teaching mode can stimulate the independent learning ability and critical thinking ability of nursing interns, promote the organic combination of theory and practice, improve their ability to comprehensively use theoretical knowledge to analyze and solve practical problems, and improve teaching effectiveness. [ABSTRACT FROM AUTHOR]

Context: Workplace-based assessment (WPBA) is an essential component of competency-based assessment addressing the "does" level. The study was planned to understand the perceptions and experiences of medical faculties with WPBA for its formal adoption under CBME. Aim: To obtain faculty perceptions and their experiences with WPBA as a medical educator. Settings and Design: A cross-sectional survey was conducted as a part of an online web discussion on WPBA among 38 faculties. Materials and Methods: The information was collected through an online semi-structured questionnaire and data were analyzed using percentages, proportions, and themes. Results: The majority were 31-50 years, females and professors. Directly observed procedural skills (DOPS), case-based discussion (CBD), and logbooks were commonly used tools. The challenges in WPBA practice were hesitancy, time constraints, lack of resources, complexity of tools, and pandemic situation. Conclusions: practice of WPBA tools was perceived positively, however a huge gap was noticed between knowledge and practice of WPBA tools. [ABSTRACT FROM AUTHOR]

Purpose: Whether the rating result of mini-clinical evaluation exercise (Mini-CEX) for rating clinical skills is reliable is of a medical trainee's great concerns. The objectives of this study were to analyze the test-retest reliability, interrater reliability and internal consistency reliability of Mini-CEX. Methods: Three clinical scenarios, each played by a standardized patient and resident, were developed and videotaped. A group of assessors were recruited to rate the resident's clinical skills using Mini-CEX with a nine-point grading scale in each videotaped clinical scenario. Each assessor was required: (1) to watch the videotaped clinical scenarios a sequential order; (2) to rate each medical trainee's clinical skills in each clinical scenario for two rating sessions, and there must be a minimum three-week interval between the first and the second Mini-CEX rating session. Results: A total of 38 assessors participated in this study. This study showed that: (1) an assessor carried out similar rating reuslts under the same clinical performance based on an acceptable test-retest reliability (Pearson's correlation coefficients = 0.24–0.76, P value=

OBJECTIVE: To determine the effectiveness of Mini-CEX as a formative assessment instrument in improving the clinical skills of postgraduate residents in Pediatrics. METHODOLOGY: This cross-sectional study was conducted from January to August 2021 at Ziauddin Medical University. A total of 176 Mini-CEX encounters were conducted on twenty-two Pediatric postgraduate residents by eight faculty members. The non-probability convenience technique was used for sampling. Each resident underwent one Mini-CEX encounter per month, and the ratings were recorded. An Objectively Structured Clinical Evaluation (OSCE) was conducted before the first Mini-CEX session, and the last and the mean scores were compared. Data were analyzed using SPSS version 20. ANOVA was used to determine inferential statistics to calculate the p-value and the improvement in score over time to report statistical significance. RESULTS: Mean scores of all clinical competencies improved with subsequent Mini-CEX sessions. Maximum improvement was noted in clinical management skills and organization/efficiency. Marked improvement was observed in OSCE scores before the first Mini-CEX session and after the eighth session (p-value <0.001). An increase in the satisfaction rate of both faculty and residents with each subsequent Mini-CEX session was also noted. CONCLUSION: Mini-CEX effectively improves pediatric postgraduate residents' clinical learning; therefore, it should be incorporated into the national residency program. [ABSTRACT FROM AUTHOR]

Objective: Mini clinical evaluation exercise (mini-CEX) and objective structured clinical examination (OSCE) are widely acknowledged as effective measures of resident standardization training (RST) in European and American countries. However, in China primary mini-CEX and OSCE forms are mainly limited in undergraduate clinical examination. Little knowledge is available regarding the validity and right way of mini-CEX /OSCE evaluation system in advanced dental clinical education so far. This study aimed to explore whether combination of mini-CEX and OSCE represents a global-dimension assessment for postgraduate clinical competence in RST. Methods: Postgraduates who received RST from June 2017 to June 2019 were selected and evaluated by modified mini-CEX/OSCE scales. Each student received evaluations at least twice in the initial and final stages of training (tested every 4 months). A questionnaire was conducted to investigate the satisfaction with the arrangement of RST. Results: Mini-CEX/OSCE test results indicated that postgraduates have significantly improved their comprehensive competence in RST projects in the department of prosthodontics (P < 0.05). Compared to other master of Stomatology students, postgraduates taking up prosthodontics master's degree have made more progresses through a training period of up to 1 year and four sessions of face-to-face feedback tutoring (P < 0.05). Survey results revealed high level of satisfaction on clinical practice evaluation. Conclusion: Modified mini-CEX/OSCE combined evaluation system is an effective and reliable assessment tool for clinical comprehensive ability in the RST of professional graduates and can fully highlight their respective advantages on the improvement of students' clinical competency, especially after several rounds of assessments. [ABSTRACT FROM AUTHOR]

Background Traditional assessments in postgraduate medical training tend to emphasize cognitive skills while often neglecting the psychomotor and affective domains. The mini-clinical evaluation exercise (mini-CEX) addresses these limitations by evaluating clinical, communication, and humanistic skills with immediate feedback. This study aimed to evaluate the acceptability and feasibility of the mini-CEX in assessing neurology cases among postgraduate internal medicine students at a medical college in North India. Methods Between March and July 2024, 10 postgraduate medicine students and 14 faculty members participated in the study. Each student completed at least four mini-CEX sessions, during which performance across seven core skills was rated using a nine-point scale. Immediate feedback was provided by faculty following each session. Both student and faculty feedback were collected to assess the acceptability and feasibility of the mini-CEX. Descriptive statistics were used to evaluate these factors, while paired t-tests were applied to measure improvements in student performance. Results A total of 63 mini-CEX sessions were conducted, with an average observation time of 18.77 minutes and an average feedback time of 10.08 minutes. Significant improvements in clinical skills were observed among second-year (P = 0.04) and third-year (P = 0.01) residents, with second-year residents also showing gains in humanistic skills (P = 0.03). Student feedback was largely positive, with nine out of 10 (90%) participants expressing satisfaction and eight out of 10 (80%) recommending the continued use of the tool. Faculty feedback indicated that 10 of 14 (71.4%) supported its continued use and eight of 14 (57%) found it better than traditional assessment methods. Conclusions The mini-CEX is a feasible and acceptable formative assessment tool for neurology cases, effectively enhancing clinical and communication skills. Despite concerns regarding subjectivity, the mini-CEX shows promise for wider implementation in postgraduate, and potentially undergraduate, medical training., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Khan et al.)

Khalid Bashir, Wajeeha Arshad, Aftab Mohammad Azad, Shukri Alfalahi, Ashid Kodumayil, Amr Elmoheen Hamad Medical Corporation, Doha, QatarCorrespondence: Wajeeha ArshadHamad General Hospital, PO Box 3050, Doha, QatarEmail WArshad@hamad.qa; wajeeha_arshad44@yahoo.comBackground: Mini Clinical Evaluation Exercise (Mini-CEX) has been adapted to different specialties in clinical practice but with very little evidence documented about its use for residency training in the emergency department (ED). This study aims to assess its acceptability and feasibility as a formative tool in the busy emergency department.Materials and Methods: Both the faculty members and the emergency medicine residents were sent a validated questionnaire using Google forms, and the results were analyzed using simple statistical tools.Results: Forty-nine residents and 58 faculty participated in the survey. The study was carried out over a period of 4 months. The resident’s completion rate was 96% (49 out of 51), while faculty completion rate was 96% (58 out of 60). The time for Mini-CEX completion ranged from 10 to 20 minutes. Most of the residents were satisfied with Mini-CEX as an assessment tool. Twelve residents expressed their concern regarding available time during busy clinical shifts. Most of the faculty agreed with the benefits of using Mini-CEX as a formative assessment tool. Several of them commented that they need “protected time” and “more training” to use this tool to provide maximum benefit to the residents.Conclusion: Despite busy nature of ED, Mini-CEX has been identified as an acceptable learning tool for residents in emergency medicine. Based on the faculty’s feedback and comments, several faculty development workshops were conducted to improve faculty skills in carrying assessments by using Mini-CEX, and protected time is provided to some faculty members to carry out these formative assessments for the benefit of the residents.Keywords: Mini-CEX, emergency medicine department, residency training, rater, faculty member

Abstract Background The traditional curriculum for medical students in Japan does not include sufficient opportunities for students to develop their skills for musculoskeletal (MSK) examination and clinical reasoning and diagnosis. Therefore, an effective programme is required to help medical students and residents improve their clinical skills in MSK. This paper aims to assess the clinical skills of medical students who have participated in a peer role-playing simulation programme using a mini clinical evaluation exercise (mini-CEX). Methods Participants were 90 female medical students who were completing their first orthopaedic clinical clerkship. They were divided into two groups. The simulation group participated in a role-play focussed on MSK cases as low-fidelity simulation, a structured debriefing with the course supervisor, and a self-reflection on Day 1 (n = 64). The control group did not participate in the role-play due to randomised clerkship schedules (n = 26). On Day 2 of the intervention, we observed and assessed all participants’ performances during MSK outpatient encounters using the mini-CEX. We compared the mini-CEX score between the simulation group and the control group; the Wilcoxon rank-sum test was used for statistical analysis. Results The mini-CEX scores for physical examination, clinical reasoning and diagnosis, and overall clinical competency were significantly higher in the simulation group than in the control group (p

Objetivo: Evaluar competencias profesionales de una residencia de Ortopedia y Traumatología Infantil. Instrumentos pedagógicos utilizados: Mini-Clinical Evaluation Exercise (Mini-CEX) y Direct Observation of Procedural Skills (DOPS) para competencias clínicas y quirúrgicas, respectivamente. Ambas evalúan la cúspide de la pirámide de Miller; se precisaron su confiabilidad y validez. Materiales y Métodos: Estudio observacional prospectivo de una cohorte de seis residentes de primero, segundo y tercer año quienes fueron evaluados por seis docentes en diversos contextos y situaciones reales: consultorio externo y de guardia, sala de internación, interconsultas, quirófano y sala de yesos. Resultados: Se realizaron 65 observaciones. Cada residente fue evaluado como media en 10 oportunidades por entre 3 y 6 docentes. Para las variables clínicas, en general, los residentes más antiguos obtuvieron valores sobresalientes y los residentes de primer año, valores satisfactorios. No hubo diferencias significativas para las competencias quirúrgicas globalmente, pero los residentes de tercer año fueron más competentes para resolver situaciones inesperadas. El coeficiente de Cronbach fue superior a 0,90. Conclusiones: Ambos instrumentos de evaluación tuvieron una elevada confiabilidad. El método estadístico permitió individualizar exactamente las fragilidades y fortalezas de la residencia. El coeficiente de Cronbach obtuvo un valor de alto impacto psicométrico.

Background: Mini-CEX is a popular workplace exam that includes direct observation and a feedback conversation. This evaluation occurs in a workplace setting as part of the daily work. Self-efficacy is a mandatory soft skill for nursing students during an internship. Therefore, this study aims to identify the effect of Mini-CEX on self-efficacy among these students. Design and methods:A quasi-experiment design was conducted with a control group. All the nursing student intents of the Sari Mutiara Indonesia University were considered as the study population. This population was then divided into one control and one intervention group of 24 and 25 students, respectively. Subsequently, data collection was carried out using general selfefficacy. Results: The results showed the self-efficacy was low in the control group (66.7%), and Mini-CEX was discovered to have a significant effect on self-efficacy among nursing students undergoing internships (p=0.000). Conclusions: The Mini-CEX was concluded to effectively increase self-efficacy among nursing students and is suggested as a mandatory method for evaluating these students. [ABSTRACT FROM AUTHOR]

Purpose: Whether the rating result of mini-clinical evaluation exercise (Mini-CEX) for rating clinical skills is reliable is of a medical trainee's great concerns. The objectives of this study were to analyze the test-retest reliability, interrater reliability and internal consistency reliability of Mini-CEX.Methods: Three clinical scenarios, each played by a standardized patient and resident, were developed and videotaped. A group of assessors were recruited to rate the resident's clinical skills using Mini-CEX with a nine-point grading scale in each videotaped clinical scenario. Each assessor was required: (1) to watch the videotaped clinical scenarios a sequential order; (2) to rate each medical trainee's clinical skills in each clinical scenario for two rating sessions, and there must be a minimum three-week interval between the first and the second Mini-CEX rating session.Results: A total of 38 assessors participated in this study. This study showed that: (1) an assessor carried out similar rating reuslts under the same clinical performance based on an acceptable test-retest reliability (Pearson's correlation coefficients = 0.24-0.76, P value=<0.01-0.14); (2) assessors gave similar rating results to a medical trainee's clinical performance based on a good interrater reliability (intra-class correlation coefficient = 0.57-0.83, P value=<0.01-0.03); and (3) the items reflected unidimensionally a construct-a medical trainee's clinical skills based on an excellent internal consistency reliability (Cronbach's alpha = 0.92-0.97).Conclusion: This study convincingly showed that Mini-CEX is a reliable assessment tool for rating clinical skills, and can be widely used to assess medical trainees' clinical skills. [ABSTRACT FROM AUTHOR]

Ihab Shafek Atta,1,2 Rajab A Alzahrani3 1Pathology Department, Faculty of Medicine, Al-Azhar University, Assuit, Egypt; 2Pathology Department, Faculty of Medicine, Albaha University, Albaha, Saudi Arabia; 3Surgery Department, Otolaryngology Division, Faculty of Medicine, Albaha University, Albaha, Saudi ArabiaCorrespondence: Ihab Shafek AttaPathology Department, Faculty of Medicine, Al-Azhar University, Assuit 71524, EgyptTel +20882148103/4Fax + 20882148119Email Ihab.bassyouny@azhar.edu.egRajab A AlzahraniSurgery Department, Otolaryngology Division, Faculty of Medicine, Albaha University, Saud ArabiaTel +966509766298Email drrajabg@gmail.comAim: Multidisciplinary, as a term, is used to define people from different scientific backgrounds working together, each drawing on their field of expertise. Some related terms are frequently used interchangeably, such as interdisciplinary and transdisciplinary, but they are confusing and ambiguous. Introduction of a multidisciplinary teaching method in the early phases of medical curricula is insufficient for effective learning. Here, we aim to implement a multidisciplinary approach in the early phase of medical education and identify outcomes.Methods: Two groups were evaluated in this study, each representing phases II and III of the Albaha medical curriculum, and including 90 and 86 students, respectively. “Hearing tests and their clinical applications” was selected as a subject to evaluate the understanding of special senses as studied by the phase II group, while “pathology of otolaryngology-related tumors and clinical correlations” was selected as a subject to evaluate the understanding of otolaryngology as studied by the phase III group. These subjects were selected by faculty members from otolaryngology, pathology and physiology departments and taught in successive stations. Teaching sessions were followed by a formative test that included 10 multiple-choice questions and a mini-clinical evaluation exercise (mini-CEX). A questionnaire to evaluate student satisfaction was completed after the exam.Results: Students’ satisfaction for the “hearing tests and their clinical applications” and “pathology of otolaryngology-related tumors and clinical correlations” subjects were 80% and 90.5%, respectively. The formative assessment revealed good student performance at 63.28%, and 60.46% of all students in both phases attained scores above 80%.Conclusion: Introduction of a multidisciplinary approach early in the medical curriculum improves knowledge and skill acquisition. This is reflected in student performance, especially if evaluated using the mini-CEX format, thus providing rapid feedback to students concerning their performance.Keywords: integration, multidisciplinary, mini-CEX, otolaryngology, pathology, student performance

Abstract Background Cultural differences might challenge the acceptance of the implementation of assessment formats that are developed in other countries. Acceptance of assessment formats is essential for its effectiveness; therefore, we explored the views of students and specialists on the practicality and impact on learning of these formats. This study was conducted to explore Indonesian students’ and specialists’ appreciation of the implementation of the Mini-Clinical Evaluation Exercise (Mini-CEX) in Indonesian clerkships. Methods This study was conducted at the Universitas Gadjah Mada, Indonesia. Participants were 52 students and 21 specialists in neurology and 78 students and 50 specialists in internal medicine. They were asked to complete a 19-item questionnaire that covered the characteristics of the mini-CEX such as its practicality, and the impact on learning and professional development. We used a Mann-Whitney U test to analyse the data. Results In total, 124 students (46 from neurology and 78 from internal medicine) and 38 specialists (13 from neurology and 25 from internal medicine) participated in this study. Students and specialists were positive about the practicality of the mini-CEX and the impact of this assessment format on learning and on professional development. The Mann-Whitney U test showed that there were no significant differences between students’ and specialists’ opinions on the mini-CEX, except for 2 items: specialists’ appreciation of direct observation (mean rank = 93.16) was statistically significantly higher than students’ appreciation of it (mean rank = 77.93; z = 2.065; p

Purpose: This study investigated whether the mini-clinical evaluation exercise (mini-CEX) has been successfully integrated into the Chinese context, following its introduction as part of the national general training programme. Materials and methods: Online questionnaires (N = 91) and interviews (N = 22) were conducted with Year 1 trainee doctors and clinical supervisors at a cancer hospital in China to explore users' experiences, attitudes and opinions of the mini-CEX. Results" Trainees were more likely than supervisors to report understanding the purpose of the mini-CEX and agree that it encouraged reflection and helped improve overall performance. Both trainees and supervisors felt that it provided a framework for learning, that it was useful in identifying underperformance, and that it informed learning progression. Groups were equally positive about the commitment of their counterpart in the process and valued the focus on detailed feedback. It was perceived as cultivating the learner–teacher relationship. Overall, both groups felt they 'bought in' to using the mini-CEX. However, concerns were raised about subjectivity of ratings and lack of benchmarking with expected standards of care. Conclusions: Chinese trainees and supervisors generally perceived the mini-CEX as an acceptable and valuable medical training tool, although both groups suggested enhancements to improve its efficacy. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the feasibility and acceptability of Mini-CEX as a formative WPBA tool at Rehman Medical College. To compare the annual exam short case scores of students with their internal Mini-CEX scores. Study design: Cross Sectional study. Setting: Rehman Medical College, Peshawar. Period: January to February 2016. Material & Methods: Mini-CEX was implemented for the first time in a medical college of Khyber Pakhtunkhwa after training of faculty & students on simulators. 100 MBBS students of Final Professional were included in the study through universal sampling. Completed Mini-CEX forms were collected weekly by Department of Medical Education (DME), and data entered in an Excel file. Mini-CEX scores of graduates were reviewed, compared and correlated with Khyber Medical University (KMU) practical exam scores in the same subjects for short cases. Results: 84 students were selected after data cleaning. Total required Mini-CEX were, 2338, submitted were 2563 with maximum mean submission/student of 5.32 in Obs/Gyn against a required mean of 3.32 (n=83, total rotation period = 04 weeks). The minimum requirement was 01 Mini-CEX/week. Total mean submission for all clinical disciplines was 7.67/student against a required mean of 6.27/student, showing ease and feasibility in implementation and student compliance. Significant correlation with KMU annual examination scores was observed only for Surgery (p=0.04). The correlation was insignificant for the other 03 disciplines of Medicine, Pediatrics and obstetrics and Gynecology with p >0.05. Conclusion: Mini-CEX implementation is feasible and acceptable tool for formative WPBA in undergraduate clinical training. The student performance in Mini-CEX does not have a major effect on their annual exams scores. [ABSTRACT FROM AUTHOR]

Abstract Background Clinical pharmacists must have a complex combination of academic knowledge and practical experience that integrates all aspects of practice. Taiwan’s Ministry of Health and Welfare in 2007 launched the Postgraduate Year (PGY) training program to increase the standard of pharmaceutical care. This study aims to develop a pharmacist-specific Chinese-language Mini-Clinical Evaluation Exercise (Mini-CEX) to evaluate the professional development of postgraduate year trainees. Method The specialized Mini-CEX was developed based on the core competencies of pharmacists, published literature, and expert opinion. A pilot test and evaluator workshop were held prior to the administration of the main test. Fifty-three samples were recruited. The main study was conducted at two regional teaching hospitals and a medical center teaching hospital in Taiwan between February and June 2012. The results were analyzed with the kappa statistic (inter-rater reliability) and descriptive statistics, while the Kruskal-Wallis test was used to examine the PGY trainees’ Mini-CEX scores based on their performances. Results Trainees who had recently completed PGY programs (C-PGY) and 2nd year PGY trainees (PGY2) earned excellent scores, while the 1st year PGY trainees (PGY1) earned satisfactory scores in overall performance. C-PGY and PGY2 trainees also performed significantly better than PGY1 trainees in the organization and efficiency domain, and the communication skills domain. Conclusion This study demonstrates the feasibility of using the newly developed pharmacist-specific Chinese-language version of the Mini-CEX instrument to evaluate the core competencies of PGY trainees in clinical settings.

Introducción: la evaluación kinesiológica contempla la realización de una rigurosa historia clínica y examen físico que orientan a establecer un diagnóstico, un pronóstico funcional, y es la base del plan de intervención. Esta competencia requiere de experiencia y razonamiento clínico para la toma de buenas decisiones terapéuticas. Los resultados históricos de las evaluaciones de aprendizajes del internado, concluyen que esta competencia tiene bajo nivel de desempeño, por lo que se deben mejorar las estrategias utilizadas para su aprendizaje durante el internado. El mini-CEX, es un instrumento de evaluación para el aprendizaje, que promueve la observación y feedback en el sitio de trabajo. Objetivo: diseñar e implementar un instrumento de evaluación para el aprendizaje de la evaluación kinesiológica durante el internado profesional de la Carrera de Kinesiología de la PUC. Método: estudio prospectivo, utilizando la metodología de investigación acción, diseñado en 4 etapas. Resultados: se obtuvo un instrumento de evaluación para el aprendizaje, el mini-CEX, adaptado a las necesidades del internado profesional de kinesiología. El estudio piloto reportó buena aceptación entre estudiantes y docentes. La percepción de los internos es que son más observados y que las destrezas asociadas a la evaluación kinesiológica mejoraron luego del estudio. Conclusiones: el instrumento reportó un tiempo de aplicación bajo (35 min.), lo que beneficiaría instancias de observación directa y feedback dentro de los internados. Es necesaria una aplicación a gran escala, que contribuya a determinar su validez y confiabilidad. Se requiere una capacitación formal a los docentes evaluadores y ajustar la escala.

Introduction: The mini-clinical evaluation exercise (mini-CEX) allows for assessment and subsequent feedback across a range of individual clinical cases, although much of what is assessed is left implicit. After the performance by a trainee, further observation of appropriate clinical performance by the tutor provides a strong standard of reference for effective learning. Methods: In each mini-CEX encounter one final year resident clinically assessed an unfamiliar patient in the presence of peers and a tutor. The tutor then demonstrated the appropriate clinical behaviour. Twelve peers rated the performance of the resident before and after the tutor-demonstrated feedback (TDF). The encounters with the first cases by each of the participants were completed one by one and the cycles of encounters with the next cases by each resident were similarly continued. Results: All 13 participants completed six mini-CEX encounters over one year with an overall response rate of 95% for peer-assessment ratings (PARs). There was a total of 1772 PAR forms each with seven parameters and 1772 peer-satisfaction rating (PSR). Reliability coefficients of PARs ranged from .77 to .93. The PARs decreased significantly in each of the six cases after TDF (p

Objective: To evaluate the quality of the observed mini-CEX scores by estimating reliability coefficients and standard errors. Study Design: Quasi-experimental, co relational study. Place and Duration of Study: Pak Emirates Military Hospital Rawalpindi from Sep 2016 to Oct 2017. Material and Methods: This Quasi-experimental, correlational study was conducted with the OBGYN residents through non probability convenience sampling at Pak Emirates Military Hospital with sample size of 40. Twenty residents underwent Mini CEX (in addition to the existing teaching) while 20 had training through existing traditional teaching methods (lectures, SGDs, OPD, ward rounds, journal clubs, CPCs). Before commencing the study both faculty and Resident trainees were introduced to Mini-CEX. The faculty (CPSP accredited supervisors), were given face to face training in conducting and rating Mini-CEX by a workshop. Each of the 20 trainees took four Mini-CEX sessions over a period of one year. The clinical skills were rated on a standard adapted Mini-CEX proforma. The trainees were given immediate feedback. Action plan was made and documented on the proformas. Results: The Trainees were assessed for improvement in clinical skills over the period of 12 months; and a trend of increased performance was obsessed amongst the trainees with each subsequent evaluation, supporting the construct validity of the instruments. Conclusions: The study showed that the mini-CEX is a potentially powerful tool to provide high-quality, interactive feedback that could contribute to improvement in trainees’ clinical skills.

Objective: To assess feasibility, acceptability and effectiveness of launching mini-CEX as a Work Place Based Assessment tool in Obs/Gynae post-graduate residency program. Study Design: Mixed method approach. Place and Duration of Study: Obs/Gynae dept of Islamic International Medical College Rawalpindi Pakistan, from Aug 2016 to Feb 2017. Patients and Methods: Twenty one post graduate residents from first to final year MCPS/FCPS and available faculty members (10) were invited to participate. Non-probability convenience sampling was used. We adopted an amended mini-CEX tool. The residents were assessed in history taking, physical examination, clinical judgment, communication skills and professionalism. Copies of the mini-CEX forms were collected and analyzed. Results of the first and last Mini CEX scores were compared to determine the efficiency of mini-CEX. These results were analyzed using SPSS version 21. Perceptions of faculty and PG residents are expressed as average scale frequencies ± 2 standard deviation. To assess the feasibility; time taken for each encounter was noted. Mean time was calculated. The total time taken for mini-CEX encounters during the study period was extrapolated over a year. For further assessing the feasibility; considerable practical difficulties were identified. Results:Almost all the residents (18/21) and faculty members (8/10) were satisfied with the mini-CEX as a learning tool. More than 75% of the residents showed gradual improvement in scores from the first to the fourth mini-CEX. The average duration of mini-CEX was 19.51 minutes. Average time taken for the feedback was 13.08 minutes. Seventeen residents were contented with feedback of each session of mini-CEX. Majority of comments indicated that feedback was the strongest characteristic of mini-CEX. Most participants (17 residents; 8 faculty members) never or occasionally experienced trouble organizing the mini-CEX. About 27% residents felt anxious being observed. Conclusions:This study concluded that Mini-CEX is highly acceptable and feasible educational tool. Its effectiveness was established by statistically significant improvement in results of post graduate residents over a period of time. It was also useful in helping faculty to assess and to give formative feedback to residents on their clinical performance in real workplace based environment.

Background: Cultural differences might challenge the acceptance of the implementation of assessment formats that are developed in other countries. Acceptance of assessment formats is essential for its effectiveness; therefore, we explored the views of students and specialists on the practicality and impact on learning of these formats. This study was conducted to explore Indonesian students' and specialists' appreciation of the implementation of the Mini-Clinical Evaluation Exercise (Mini-CEX) in Indonesian clerkships. Methods: This study was conducted at the Universitas Gadjah Mada, Indonesia. Participants were 52 students and 21 specialists in neurology and 78 students and 50 specialists in internal medicine. They were asked to complete a 19-item questionnaire that covered the characteristics of the mini-CEX such as its practicality, and the impact on learning and professional development. We used a Mann-Whitney U test to analyse the data. Results: In total, 124 students (46 from neurology and 78 from internal medicine) and 38 specialists (13 from neurology and 25 from internal medicine) participated in this study. Students and specialists were positive about the practicality of the mini-CEX and the impact of this assessment format on learning and on professional development. The Mann-Whitney U test showed that there were no significant differences between students' and specialists' opinions on the mini-CEX, except for 2 items: specialists' appreciation of direct observation (mean rank = 93.16) was statistically significantly higher than students' appreciation of it (mean rank = 77.93; z = 2.065; p < 0.05), but students' appreciation of the item that students' past mini-CEX results affected their recent mini-CEX outcomes (mean rank = 85.29) was significantly higher than specialists' appreciation of it (mean rank = 69.12; z = 2140; p < 0.05). Conclusion: Students and specialists were positive about the mini-CEX in Indonesian clerkships, although it was developed and validated in another culture. We found only small differences between their appreciations, which could be explained by the patterns of specialist-student interaction in Indonesian culture as large power distance and low individualism country. [ABSTRACT FROM AUTHOR]

Objectives: To determine the efficacy of Mini-CEX in assessing clinical expertise of anesthesia trainee during examination at Anesthesia department of Multan Hospitals. Study Design: Prospective Observational Study. Setting: Department of Anesthesia and Intensive Care Ch. Pervez Ellahi Institute of Cardiology and Nishtar Hospital Multan. Period: January 2017 to March 2019. Material & Methods: The design of study was prospective observational study having the post-test with control group only. The size of the sample was based upon 70 trainee anesthesia being divided into two further groups: 35 trainee anesthesia were included in the control group whereas 35 trainee were part of the intervention group. The analysis of data was done by Mann Whitney test and it was descriptive type of test. Results: The mean result of Preoperative examination skills among the intervention group was greater than the control group. The mean score of Preoperative examination competence in control group was 72.11±4.56, while the mean score of Preoperative examination competence in intervention group was 81.28±2.86. The mean score of anesthesia trainees towards satisfaction of control and intervention group was 5.37±0.38 and 8.95±0.64, respectively. While the mean score of evaluators towards satisfaction of control and intervention group was 6.24±0.53 and 8.04±0.52, respectively. The difference of clinical abilities was significant among the two groups having the p value 0.000 (p<0.05). Conclusion: Clinical expertise among anesthesia trainee was significantly ameliorated after the use of Mini-CEX program. It is therefore suggested for anesthesia trainers to use the Mini-CEX program in order to determine the clinical skills among students. [ABSTRACT FROM AUTHOR]

Abstract Background One of the most frequently used assessment tools that measure the trainees’ performance in workplace is the mini-Clinical Evaluation Exercise (mini-CEX), in which an expert observes and rates the actual performance of trainees. Several primary studies have evaluated the effectiveness of mini-CEX by assessing its educational and psychometric properties. The objective of this BEME review is to explore, analyze, and synthesize the evidence considering the utility of the mini-CEX for assessing undergraduate and postgraduate medical trainees. Methods Studies reporting on mini-CEX performed in undergraduate and postgraduate medical education and providing some empirical data for mini-CEX in relation to one or more of the validity, reliability, educational impact, acceptability, and cost of mini-CEX will be included in the review. No restrictions on study design or publication date or language will be handled. To ensure comprehensiveness of our search, we will use different approaches and methods. In addition to electronic search in bibliographic databases, we will conduct forward and backward searching. We will also contact leading authors in the field of mini-CEX and will search for the gray literature. Data extractions will be done independently by two coders based on a form. If there is any discordance, a third author will resolve it. The quality assessment will be also done independently by two team members, based on critical appraisal checklists. In attempting to answer our original research questions, we will use meta-analysis or meta-synthesis. Discussion The findings of this study can be transferred to the medical education stakeholders such as administrators of medical schools, residency program directors, and faculty members. We also hope that publication of this review will encourage stakeholders who have already adopted the mini-CEX to evaluate and report its different characteristics. Lastly, we expect that we can identify gap of knowledge in this field and suggest areas for future research.

Introduction: Acquisition of clinical skills is the main aim of the compulsory clinical rotations during internship. It is left to chance that students acquire clinical skills as there is no formal assessment to ensure that skill learning has actually taken place. The best method for assessing clinical competence is Work Place Based Assessment (WPBA). Mini-clinical Evaluation Exercise (mini-CEX) and Directly Observed Procedural Skills (DOPS) are among some of the tools used for assessment of clinical competence. These tools can also be used to incorporate feedback to the students and at the same time it can be used as an excellent teaching-learning opportunity. Aim: To assess the feasibility and use of Mini-clinical evaluation exercise and directly observed procedural skills as assessment tools for assessing clinical competence of interns. Materials and Methods: This Prospective interventional study was conducted in Department of Ophthalmology of Punjab Institute of Medical Sciences, Jalandhar, Punjab, India from June 2016-June 2017. The clinical competence of interns was assessed using mini-CEX and DOPS. One Hundred interns undertook four Mini-clinical evaluation exercises each by different assessors and at least one DOPS for refraction was conducted per intern. If result was unsatisfactory, then further DOPS was undertaken till performance was satisfactory. The grading was done on the checklist (key points required) and evaluation done in points as pre-decided by assessors on a scale of 1-9 (1-3 unsatisfactory, 4-6 satisfactory and 7 to 9 superior). Satisfaction with the process of assessment by miniCEX was also graded on a 9 point scale. Overall performance of interns for the procedure of refraction was graded on a 9 point scale in DOPS. A feedback questionnaire about the conduct and acceptability of assessment tools was taken from the interns and assessors at the end of their posting using a prevalidated questionnaire. All the results were computed using SPSS software (version 22.0). Average scores of all the interns in each subcompetency of mini-CEX and DOPS were recorded. The progression of the scores was observed from first miniCEX and the fourth mini-CEX. Comparison of scores was done between mini-CEX 1 vs. mini-CEX 4 using ANOVA Post-hoc Tukey’s Test. Results: A total of 100 interns undertook 400 Mini-clinical evaluation exercise (four Mini-clinical evaluation exercise each intern) and 160 DOPS (at least one DOPS each). For Miniclinical evaluation exercise (total including 1, 2, 3 and 4) the grading was satisfactory in 76.25% (305) and unsatisfactory in 23.75 % (95). For DOPS (total=160), 62.5% (100) were graded as satisfactory and 37.5% (60) of the DOPS were graded unsatisfactory. A mean score of 8.0 was given by interns and 7.7 by faculty for their satisfaction with assessment by miniCEX. Overall performance in DOPS was graded as 6.2. Conclusion: Mini-clinical evaluation exercise and directly observed procedural skills are useful assessment tools for assessing competence in interns and further improving clinical skills. It is feasible to use these assessment methods in ophthalmology clinical setting. These assessment methods act as an effective tool for giving feedback.

Objective: This study aimed to introduce, sensitize, and train our postgraduate students and faculty of the department of general surgery with the use of mini-Clinical Evaluation Exercise (mini‑CEX) and to assess the perception of students and faculty towards it., Material and Methods: A cross‑sectional observational study was conducted over a period of four months. Ten surgery residents in the department were asked to volunteer to participate and five professors conducted the session. Five sessions of mini‑CEX (nine points) were conducted for each resident in different settings of the out‑patient department (OPD) and in‑patient department (IPD). A total of five skills were tested. Feedback from faculty and residents regarding the perception of mini‑CEX was also taken., Results: A statistically significant difference in mean scores of all domains was observed comparing the first and last assessment (p<0.05). Hundred percent of the residents scored superior category (7-9) in the final assessment in all domains, whereas the maximum was in a satisfactory scoring grade in 1st assessment. The time taken for the assessment significantly reduced from 1st assessment to the last assessment in OPD and IPD settings (p=0.001). The mini-CEX assessment tool got 100% feedback from faculty in terms of skill improvement, method, attitude of residents, and ability to identify gaps in knowledge. However, one assessor thought that "time given for assessment" was inadequate and more effort was required than the usual traditional assessment methods. The most identified problem faced by residents was that the "time given during assessment" was less (50%); however, overall residents also found it valid, effective, and helpful in identifying knowledge gaps and improving clinical and communication skills., Conclusion: Mini‑CEX improves the learning environment in residency and also leads to improvement in medical interviewing skills, physical examination skills, humanistic qualities/professionalism, and counseling skills. So, it can be used for residency training in clinical departments., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Rai et al.)

Introduction: Acquisition of clinical skills is the main aim of the compulsory clinical rotations during internship. It is left to chance that students acquire clinical skills as there is no formal assessment to ensure that skill learning has actually taken place. The best method for assessing clinical competence is Work Place Based Assessment (WPBA). Mini-clinical Evaluation Exercise (mini-CEX) and Directly Observed Procedural Skills (DOPS) are among some of the tools used for assessment of clinical competence. These tools can also be used to incorporate feedback to the students and at the same time it can be used as an excellent teaching-learning opportunity. Aim: To assess the feasibility and use of Mini-clinical evaluation exercise and directly observed procedural skills as assessment tools for assessing clinical competence of interns. Materials and Methods: This Prospective interventional study was conducted in Department of Ophthalmology of Punjab Institute of Medical Sciences, Jalandhar, Punjab, India from June 2016-June 2017. The clinical competence of interns was assessed using mini-CEX and DOPS. One Hundred interns undertook four Mini-clinical evaluation exercises each by different assessors and at least one DOPS for refraction was conducted per intern. If result was unsatisfactory, then further DOPS was undertaken till performance was satisfactory. The grading was done on the checklist (key points required) and evaluation done in points as pre-decided by assessors on a scale of 1-9 (1-3 unsatisfactory, 4-6 satisfactory and 7 to 9 superior). Satisfaction with the process of assessment by mini- CEX was also graded on a 9 point scale. Overall performance of interns for the procedure of refraction was graded on a 9 point scale in DOPS. A feedback questionnaire about the conduct and acceptability of assessment tools was taken from the interns and assessors at the end of their posting using a prevalidated questionnaire. All the results were computed using SPSS software (version 22.0). Average scores of all the interns in each subcompetency of mini-CEX and DOPS were recorded. The progression of the scores was observed from first mini- CEX and the fourth mini-CEX. Comparison of scores was done between mini-CEX 1 vs. mini-CEX 4 using ANOVA Post-hoc Tukey's Test. Results: A total of 100 interns undertook 400 Mini-clinical evaluation exercise (four Mini-clinical evaluation exercise each intern) and 160 DOPS (at least one DOPS each). For Miniclinical evaluation exercise (total including 1, 2, 3 and 4) the grading was satisfactory in 76.25% (305) and unsatisfactory in 23.75% (95). For DOPS (total=160), 62.5% (100) were graded as satisfactory and 37.5% (60) of the DOPS were graded unsatisfactory. A mean score of 8.0 was given by interns and 7.7 by faculty for their satisfaction with assessment by mini- CEX. Overall performance in DOPS was graded as 6.2. Conclusion: Mini-clinical evaluation exercise and directly observed procedural skills are useful assessment tools for assessing competence in interns and further improving clinical skills. It is feasible to use these assessment methods in ophthalmology clinical setting. These assessment methods act as an effective tool for giving feedback. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the quality of the observed mini-CEX scores by estimating reliability coefficients and standard errors. Study Design: Quasi-experimental, co relational study. Place and Duration of Study: Pak Emirates Military Hospital Rawalpindi from Sep 2016 to Oct 2017. Material and Methods: This Quasi-experimental, correlational study was conducted with the OBGYN residents through non probability convenience sampling at Pak Emirates Military Hospital with sample size of 40. Twenty residents underwent Mini CEX (in addition to the existing teaching) while 20 had training through existing traditional teaching methods (lectures, SGDs, OPD, ward rounds, journal clubs, CPCs). Before commencing the study both faculty and Resident trainees were introduced to Mini-CEX. The faculty (CPSP accredited supervisors), were given face to face training in conducting and rating Mini-CEX by a workshop. Each of the 20 trainees took four Mini-CEX sessions over a period of one year. The clinical skills were rated on a standard adapted Mini-CEX proforma. The trainees were given immediate feedback. Action plan was made and documented on the proformas. Results: The Trainees were assessed for improvement in clinical skills over the period of 12 months; and a trend of increased performance was obsessed amongst the trainees with each subsequent evaluation, supporting the construct validity of the instruments. Conclusions: The study showed that the mini-CEX is a potentially powerful tool to provide high-quality, interactive feedback that could contribute to improvement in trainees' clinical skills. [ABSTRACT FROM AUTHOR]

Objective: To assess feasibility, acceptability and effectiveness of launching mini-CEX as a Work Place Based Assessment tool in Obs/Gynae post-graduate residency program. Study Design: Mixed method approach. Place and Duration of Study: Obs/Gynae dept of Islamic International Medical College Rawalpindi Pakistan, from Aug 2016 to Feb 2017. Patients and Methods: Twenty one post graduate residents from first to final year MCPS/FCPS and available faculty members (10) were invited to participate. Non-probability convenience sampling was used. We adopted an amended mini-CEX tool. The residents were assessed in history taking, physical examination, clinical judgment, communication skills and professionalism. Copies of the mini-CEX forms were collected and analyzed. Results of the first and last Mini CEX scores were compared to determine the efficiency of mini-CEX. These results were analyzed using SPSS version 21. Perceptions of faculty and PG residents are expressed as average scale frequencies ± 2 standard deviation. To assess the feasibility; time taken for each encounter was noted. Mean time was calculated. The total time taken for mini-CEX encounters during the study period was extrapolated over a year. For further assessing the feasibility; considerable practical difficulties were identified. Results: Almost all the residents (18/21) and faculty members (8/10) were satisfied with the mini-CEX as a learning tool. More than 75% of the residents showed gradual improvement in scores from the first to the fourth mini-CEX. The average duration of mini-CEX was 19.51 minutes. Average time taken for the feedback was 13.08 minutes. Seventeen residents were contented with feedback of each session of mini-CEX. Majority of comments indicated that feedback was the strongest characteristic of mini-CEX. Most participants (17 residents; 8 faculty members) never or occasionally experienced trouble organizing the mini-CEX. About 27% residents felt anxious being observed. Conclusions: This study concluded that Mini-CEX is highly acceptable and feasible educational tool. Its effectiveness was established by statistically significant improvement in results of post graduate residents over a period of time. It was also useful in helping faculty to assess and to give formative feedback to residents on their clinical performance in real workplace based environment. [ABSTRACT FROM AUTHOR]

Introduction: The Mini-Clinical Evaluation Exercise (Mini-CEX ) is widely used to assess clinical performance because of its practicality. Although initial studies have supported its reliability and validity, the utility of Mini-CEX is under serious debate due to inconsistencies in rater judgments. This study aimed to review the relevant literature on the utility of Mini-CEX in order to find out the influencing factors on Mini-CEX scores. Methods: In this narrative review study,the MEDLINE, EMBASE, SCOPUS, SID & Magiran were searched to retrieve the relevant articles published from 1995 to 2014, using the key words such as Mini-CEX , ‘utility’, ‘validity’, ‘reliability’,‘score variability’. Subsequently, nineteen relevant studies out of 51 articles were selected to be reviewed. Results: Factors influencing Mini-CEX scores were related to the raters, rating forms and clinical exposures, in order of importance. Variability in raters’ stringency and leniency and high intercorrelation between items were the most influencing factors affecting test scores. The results of the studies regarding factors such as rater trainingon Mini-CEX scores were not conclusive. Conclusion: Considering the inconsistencies in Mini-CEX exam scores and uncertainty about the influencing circumstances on scoring, it is recommended that Mini-CEX scores should not be used for summative assessment purposes, especially in order to rank the performance of the students.