Graphical Instructions for Administration and Scoring the Mini-Cog: Results of a Randomized Clinical Trial

To develop a novel set of graphical Mini-Cog instructions designed to aid clinicians previously untrained on the Mini-Cog in accurate administration and scoring and to determine whether use of these graphical instructions improved the speed and accuracy of deployment of this tool.

Randomized clinical trial.

Testing was conducted in a simulated environment with a mock patient.

Registered nurses working in inpatient or outpatient settings at a large academic medical center who had no prior exposure to or training with the Mini-Cog (N=92).

Our primary outcome was the composite proportion of nurses who made errors in administration or scoring of the Mini-Cog.

None of the nurses in the graphical instruction group and 28 (61%) in the standardized instructions group (15 (33%) made administration errors, 22 (48%) made scoring errors) made errors. Nurses randomly assigned to the graphical group were able to read (median 36 vs 54 seconds, P<.001), administer (46 vs 62 seconds, P<.001), and score (15 vs 84 seconds, P<.001) the Mini-Cog more quickly than those in the standardized instructions group.

Graphical instructions increase the accuracy and speed of test administration in nurses without prior training in Mini-Cog administration. Further research is necessary to confirm these findings and evaluate the use of this method in other healthcare professionals and settings.