The mini-CEX (clinical evaluation exercise): a preliminary investigation

Area of Science:

• Medical Education
• Clinical Skills Assessment

Background:

• The traditional clinical evaluation exercise (CEX) has limitations in assessing resident competency.
• A need exists for a more comprehensive and reproducible evaluation tool in medical training.

Purpose of the Study:

• To collect preliminary data on the mini-CEX (clinical evaluation exercise) as a tool for assessing resident clinical skills.
• To evaluate the feasibility, satisfaction, and reproducibility of the mini-CEX.

Main Methods:

• Faculty members evaluated residents using the mini-CEX across 5 internal medicine training programs.
• 388 mini-CEX encounters involved 88 residents and 97 evaluators in inpatient and ambulatory settings.
• Each encounter involved observing a focused history and physical, followed by diagnosis, treatment planning, and feedback.

Main Results:

• Mini-CEX encounters, though slightly longer than planned (median 25 minutes), covered a broad range of clinical problems.
• Both residents and evaluators reported satisfaction with the mini-CEX format.
• The mini-CEX demonstrated higher reproducibility and comparable measurement characteristics to other assessment methods.

Conclusions:

• The mini-CEX effectively assesses residents across diverse clinical situations with improved reproducibility and feedback opportunities.
• While administration may require more scheduling, the mini-CEX offers advantages over the traditional CEX.
• The American Board of Internal Medicine recommends the mini-CEX as a valuable adjunct or alternative assessment method.