The Need for MiniCEX

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The Need for Mini-CEX

• Kichu Nair

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Clinical Performance Assessment
As a student, unfortunately our grades often
reflect our relationship with doctors rather than
patients. Student Quote Lane 2000
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Alignment

• Curriculum
• Assessment
• Outcome

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Considerations choosing assessment methods

• Reliability
• Validity
• Feasibility/cost
• Educational Impact

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Need for good assessment

• A system of assessment that functions well can
• Improve education
• Ensure highest level of safety for patients, best
  quality of care
• Reassure us training is best quality

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Does
Shows how
Knows how
Knows
Modified from Miller GE. The assessment of
clinical skills/competence/performance. Academic
Medicine (Supplement) 1990 65 S63-S7.
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Assessment Tools Clinical Performance

• OSCE GOLD STANDARD
• Traditionally assess history/physical examination
• Adapted to assess counseling, ethics, procedures
• Use of direct observation of standardized
  patients, experienced faculty observer and
  multiple stations

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OSCE Limitations

• Compartmentalize skills
• Time consuming to organize
• Cost/Feasibility

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What is Mini CEX

• Mini clinical examination
• Assessment tool where an examiner observes a
  trainee in a clinical encounter , evaluates
  performance and then provide feedback.
• Part of routine educational process
• 20 10 minutes
• Should have blue print

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Mini-CEX

• Takes about 20 minutes with up to 10 minutes
  feedback
• Covers
• patient history/interview
• physical examination
• problem formulation
• professionalism/humanism
• management plan

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Assessment MINI-CEX
The mini-Clinical Evaluation Exercise (mini-CEX)
is a performance-based assessment tool No
Standardised Patients Flexible Valid and
Reliable in certain settings
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Assessment MINI-CEX
The ideal assessment system performance-based m
ulti-competency real-life setting reliable,
valid, feasible
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Principles of Assessment and Feedback

• Create Appropriate Environment
• Observe!!
• Be aware of competencies being addressed
• Use your expertise
• Provide Appropriate Feedback

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Does
Shows how
Knows how
Knows
Modified from Miller GE. The assessment of
clinical skills/competence/performance. Academic
Medicine (Supplement) 1990 65 S63-S7.