Assessing Residents in the Department of Surgery at a Tertiary Care Centre Using Mini-Clinical Evaluation Exercise (Mini-CEX)

Abstract

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.

Introducing Mini Clinical Evaluation Exercise for Intern Assessment in Shahid Beheshti University's Pediatrics Department

“…During every encounter, the assessor records the date, the type of visit (new or follow-up), the setting (ambulatory, inpatient, outpatient), the minutes spent monitoring the encounter, and the total time spent giving feedback. The validated faculty feedback and the intern feedback questionnaires with likert scale [1][2][3][4][5] The mentioned questioner used for revealing their satisfaction levels from instant feedback. The collected data underwent qualitative and quantitative analyses.…”

“…The structured feedback it provides students and faculty is pivotal in their learning and teaching journey. The brief, 10 to 20-minute encounters assess crucial clinical skills, attitudes, and behaviors necessary for delivering high-quality care [1,2]. What sets Mini-CEX apart is its unique structure, with each encounter addressing different clinical issues and being allocated 20 minutes, with 15 minutes for the interaction and 5 minutes for feedback.…”

“…It has been reported that the faculty's lack of direct observation during patient encounters is due to limited availability. However, direct observation is critical for assessing clinical skills, including interviewing and counseling skills [1][2][3][4][5][6]. Notably, to the best of our knowledge, it is the very rst time to incorporate the consistent performance of mini-CEX for more than four years as a workplace-based assessment tool in the pediatric Department at Shahid Beheshti University of Medical Sciences in Iran.…”