A Pilot Study of Modified Mini-Clinical Evaluation Exercises (Mini-CEX) in Rotation Students in the Department of Endocrinology

Abstract

Background

The mini-clinical evaluation exercise (mini-CEX) is an excellent tool for assessing the clinical abilities of medical students in intense clinical practice. In this study, the Mini-CEX was adapted to professional questionnaires for Diabetes Mellitus (DM), and examined in medical students completing their clerkship rotation in the department of endocrinology.

Methods

From January 2021 to January 2022, all rotating medical students at Shanghai Pudong Hospital completed two mini-CEX exams before and following their rotation under the supervision and guidance of six tutors. The mini-CEX form was modified in this study primarily for inpatient management based on our clinical experience and updated DM guidelines of the American Diabetes Association (ADA), the European Association for the Study of Diabetes (EASD), and the Chinese Diabetes Society (CDS). Each component of the mini-CEX assessment, including medical interviews, physical examination, clinical judgment, clinical management, and overall clinical competence was evaluated using a nine-item questionnaire.

Results

Our findings revealed that the second-round performance on the assessments significantly improved, as indicated by higher scores on each component. The Pearson association analysis revealed that the feedback time of the first examination was markedly associated with improved overall scores (r= 0.391, p<0.001). However, no correlations were discovered between patient age, gender, disease severity disparity, or the interval between examinations (p>0.05). Additional regression analysis revealed that the feedback time during the initial examination was the most significant contributor to the increased overall scores (β=0.391, p<0.001).

Conclusion

This newly designed mini-CEX form based on current ADA and EASD guidelines may assist trainees in more effectively diagnosing and managing DM in inpatients, particularly those with macrovascular, microvascular, or peripheral nerve neuropathy. This study aims to assess the efficacy of administering a modified mini-CEX form to rotating trainees participating in an endocrine clerkship.

Keywords:

• mini-clinical evaluation exercise
• diabetes
• medical student
• feedback time

Data Sharing Statement

All data generated or analyzed during this study are included in this published article.

Ethical Approval and Consent to Participate

This study, including the examinations, obtained ethical approvals from the institution of Shanghai Pudong Hospital, Fudan University (Shanghai, China). Informed consent was received from study participants before the start of the study. The outlined guidelines and procedures were conducted in accordance with the Declaration of Helsinki.

Consent for Publication

Each participant provided written informed consent for the publication of this study.

Acknowledgments

We would like to express our gratitude to every tutor as well as other clerks in the department of endocrinology for their active participation in this project, and their selfless dedication to the growth of each rotation student despite the hectic nature of their routine clinical work.

Author Contributions

All authors made significant contributions to the work reported, whether in the conception, study design, execution, data acquisition, analysis, and interpretation, or in all these areas; participated in drafting, revising, or critically reviewing the article. All authors approved the final version of the manuscript and the journal to which the article has been submitted, and they all agreed to be accountable for all aspects of this study.

Disclosure

The authors declare that they have no conflict of interest.

Additional information

Funding

This work was supported by the Project of Key Medical Discipline of Pudong Hospital of Fudan University (Zdxk2020-11), Project of Key Medical Specialty and Treatment Center of Pudong Hospital of Fudan University (Zdzk2020-24), Integrative Medicine special fund of Shanghai Municipal Health Planning Committee (ZHYY- ZXYJHZX-2-201712), Special Department Fund of the Pudong New Area Health Planning Commission (PWZzk2017-03), Outstanding Leaders Training Program of Pudong Health Bureau of Shanghai (PWR12014-06), Pudong New Area Clinical Plateau Discipline Project (PWYgy-2021-03), the Natural Science Foundation of China (21675034), National Natural Science Foundation of China (81370932), and Shanghai Natural Science Foundation (19ZR1447500).