Assessing the Validity of a Multidisciplinary Mini-Clinical Evaluation Exercise.

Area of Science:

• Medical Education
• Clinical Skills Assessment
• Assessment Validity

Background:

• Previous mini-clinical evaluation exercise (mini-CEX) validity studies were limited to internal medicine or single disciplines.
• Generalizability of mini-CEX findings requires evidence from multidisciplinary contexts.
• This study aimed to gather further validity evidence for the mini-CEX in a broader, multidisciplinary setting.

Purpose of the Study:

• To explore the effects of discipline and rater type on mini-CEX scores.
• To examine the internal structure of the mini-CEX.
• To assess the relationship between mini-CEX scores and Objective Structured Clinical Examinations (OSCEs) in a multidisciplinary context.

Main Methods:

• Medical students completed mini-CEX forms and written exams during eight different clerkship rotations.
• Two multidisciplinary OSCEs assessed clinical skills.
• Generalizability analyses assessed reliability; factorial ANOVA examined discipline and rater type effects; correlations analyzed mini-CEX scores against OSCEs and written exams.

Main Results:

• Eighty-two students provided 781 mini-CEX ratings.
• Discipline significantly affected scores (p < .001), with faculty raters giving lower scores than non-faculty (p = .002).
• Low but significant correlations were found between mini-CEX and 4th-year OSCE scores (r = .40) and communication scores (r = .29), but not written exams.

Conclusions:

• Conflicting validity evidence emerged for the mini-CEX in this multidisciplinary context.
• Correlations with OSCEs support validity, but low-to-moderate reliability and score variability due to discipline and rater type warrant consideration.
• Findings suggest caution when implementing the mini-CEX across diverse clinical settings.