Feasibility of Mini-Clinical Evaluation Exercise as a Workplace-Based Assessment Tool for Respiratory Medicine...

Background India bears a high burden of chronic respiratory diseases, making it imperative for medical interns to acquire strong clinical reasoning, examination, and diagnostic skills in respiratory medicine. Traditional assessment methods often fail to evaluate real-time clinical performance and provide structured feedback. Workplace-based assessment tools such as the mini-clinical evaluation exercise (Mini-CEX), recommended under Competency-Based Medical Education (CBME), offer an opportunity to assess clinical competence through direct observation. However, evidence regarding its focused application in respiratory medicine during internship is limited. Aim To evaluate the feasibility and effectiveness of the Mini-CEX as a workplace-based assessment tool for assessing clinical competence in common respiratory diseases among medical interns. Methodology A prospective educational interventional study was conducted among 20 medical interns posted in the Department of Respiratory Medicine at a tertiary care hospital. Each intern underwent two Mini-CEX encounters during a one-week posting. Clinical performance was assessed across five domains using the standard Mini-CEX tool. Intern and faculty perceptions were recorded using validated 5-point Likert scale feedback forms. Knowledge gain was assessed using pre- and post-tests. Statistical analysis included descriptive statistics and paired t-tests. Internal consistency of the tool was assessed using Cronbach's alpha. Results There was a statistically significant improvement across five Mini-CEX domains between Encounter-1 and Encounter-2 (p < 0.001). Mean overall competence scores increased from 28.50 ± 3.1 to 35.65 ± 2.5. Knowledge scores showed a significant improvement with a mean gain of 7.15 points (p < 0.0001; Cohen's d ≈ 3.71). The mean time required per Mini-CEX session was 12.6 ± 3.14 minutes, with a 100% completion rate and no reported practical difficulties. Interns and faculty reported high levels of satisfaction and acceptability. The assessment tool demonstrated excellent reliability (Cronbach's α = 0.91). Conclusion Mini-CEX is a feasible, reliable, and effective formative assessment tool for evaluating and improving clinical competence in respiratory medicine among medical interns. Its integration into internship training aligns well with CBME principles and enhances both clinical performance and knowledge acquisition through structured observation and feedback.