Implementation of the mini-CEX in a paediatric emergency department

The mini-CEX is a direct observation of care delivery that provides feedback to the medical resident; and previous studies have confirmed its validity, reliability, feasibility and user satisfaction. Its application in the paediatric emergency care setting is scarce.

To assess trends in the acquisition of emergency care skills in paediatrics residents through the mini-CEX and determine the satisfaction of participants after its implementation.

Inclusion criteria: paediatrics residents in the first (MIR1) and second (MIR2) year of residency.

emergency department.

4 years (May 2019-May 2023). Evaluated competencies: anamnesis, physical examination, professionalism, clinical judgment, communication, organization-efficiency and global assessment. Number of evaluations: maximum of 6 per resident per year; each evaluation assessed 2-3 competencies (each competency could be evaluated twice per year). The evaluators were adjunct physicians in the emergency department; medical residents were assessed for training purposes. Satisfaction was rated on a scale from 1 to 9.

A total of 217 evaluations were performed on 54 residents (1-9 per resident). The median observation time was 16 min per visit (IQR, 14-25) and the feedback time was 10 min per visit (IQR, 7-15). The median anamnesis, physical examination, clinical judgment, organization-efficacy and global scores were 7 for MR1 and 8 for MRI2 residents (P = .015; P = .001, P = .076, P = .009 and P = .010, respectively). We did not find significant differences in the remaining competencies. The average satisfaction score was 9 for both evaluators and residents.

The acquisition of skills was high; with favourable outcomes observed in MRI2 relative to MRI1. The implementation of the mini-CEX was well accepted among the involved professionals.