MINI-CEX: FEASIBILITY, ACCEPTABILITY AND EFFECTIVENESS OF ITS USE IN THE LEARNING OF POST GRADUATE RESIDENTS
Keywords:Feedback, Formative assessment, Mini-CEX, Residents
Objective: To assess feasibility, acceptability and effectiveness of launching mini-CEX as a Work Place Based Assessment tool in Obs/Gynae post-graduate residency program.
Study Design: Mixed method approach.
Place and Duration of Study: Obs/Gynae dept of Islamic International Medical College Rawalpindi Pakistan, from Aug 2016 to Feb 2017.
Patients and Methods: Twenty one post graduate residents from first to final year MCPS/FCPS and available faculty members (10) were invited to participate. Non-probability convenience sampling was used. We adopted an amended mini-CEX tool. The residents were assessed in history taking, physical examination, clinical judgment, communication skills and professionalism. Copies of the mini-CEX forms were collected and analyzed. Results of the first and last Mini CEX scores were compared to determine the efficiency of mini-CEX. These results were analyzed using SPSS version 21. Perceptions of faculty and PG residents are expressed as average scale frequencies ± 2 standard deviation. To assess the feasibility; time taken for each encounter was noted. Mean time was calculated. The total time taken for mini-CEX encounters during the study period was extrapolated over a year. For further assessing the feasibility; considerable practical difficulties were identified.
Results:Almost all the residents (18/21) and faculty members (8/10) were satisfied with the mini-CEX as a learning tool. More than 75% of the residents showed gradual improvement in scores from the first to the fourth mini-CEX. The average duration of mini-CEX was 19.51 minutes. Average time taken for the feedback was 13.08 minutes. Seventeen residents were contented with feedback of each session of mini-CEX. Majority of comments indicated that feedback was the strongest characteristic of mini-CEX. Most participants (17 residents; 8 faculty members) never or occasionally experienced trouble organizing the mini-CEX. About 27% residents felt anxious being observed.
Conclusions:This study concluded that Mini-CEX is highly acceptable and feasible educational tool. Its effectiveness was established by statistically significant improvement in results of post graduate residents over a period of time. It was also useful in helping faculty to assess and to give formative feedback to residents on their clinical performance in real workplace based environment.