Mini-CEX as a workplace-based assessment tool for interns in an emergency department – Does cost outweigh value?

Victoria BrazilRoyal Brisbane and Women's Hospital, Australia;Bond University, Australia; VICTORIA BRAZIL, MBBS, FACEM, MBA, is an emergency physician and medical educator. She is a staff specialist in ED at the RBWH, and also works as Practitioner Theme Lead at the Faculty of Health Sciences and Medicine at Bond University. Her interests include workplace-based assessment and medical simulation.Correspondence[email protected]

Leanne RatcliffeRoyal Brisbane and Women's Hospital, Australia; LEANNE RATCLIFFE, MBChB Medicine, BSc (Hons) Physiotherapy, is an emergency medicine registrar. She completed her medical training in the UK. She participated in this research project during a year spent as the medical education registrar in the Department of Emergency Medicine at RBWH.

Jianzhen ZhangUniversity of Queensland, Australia; JIANZHEN ZHANG, BMed, MPH(TH), PhD, is a postdoctoral research fellow in the School of Medicine at the University of Queensland. She has worked in medical education (selection, performance and professionalism). She was granted a travel award in 2009 for her international collaborative project in China, and a ResTeach award in 2011 for her MBBS honours teaching. Her main research interest is public health research in the areas of health service utilisation, prevention of chronic diseases, primary health care, social science and behavioural medicine and socioeconomic health inequalities.

Lorna DavinRoyal Brisbane and Women's Hospital, Australia;University of Queensland, Australia; LORNA DAVIN, BAppSc, MA, GCertAdultEd, is a Principal MEO with the Centre for Medical Officer Recruitment and Education at RBWH. She has 25 years’ experience in health professional education. She is currently undertaking her PhD through the Centre for Medical Education Research and Scholarship, at University of Queensland, School of Medicine, exploring how junior doctors learn to express compassion in the clinical context. She is interested in the humanistic aspects of medical professionalism.

Abstract

Background: The mini-clinical evaluation exercise (mini-CEX) has been proposed as a method to address the deficiencies of in-training assessment for junior doctors.

Aim: Our study aimed to determine the feasibility and value of adding mini-CEX assessments to the existing assessment processes for an intern cohort in the emergency department (ED).

Methods: Interns undertook four mini-CEX assessments with senior ED medical officers, in addition to their standard in-training assessment processes. Assessment results and time taken to perform the mini-CEX assessments were recorded. Interns and assessors completed a survey regarding their perceptions of the mini-CEX assessment process.

Results: The total time taken for mini-CEX assessments during the study period was 36.51 h. If extrapolated over a year this would represent an additional direct cost to the ED of more than $A 80,000 per year. No additional interns were identified as underperforming through the addition of the mini-CEX. The mini-CEX assessment process was perceived as generally positive. Both interns and assessors felt that it provided a valid assessment of intern performance, and enabled timely and specific feedback. Significant practical difficulties in arranging and conducting mini-CEX assessments in the workplace were identified.

Conclusion: There was a significant cost to the ED as a result of adding mini-CEX encounters to interns’ performance assessment. No change in summative outcome occurred for this study cohort.

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Mini-CEX as a workplace-based assessment tool for interns in an emergency department – Does cost outweigh value?

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Mini-CEX as a workplace-based assessment tool for interns in an emergency department – Does cost outweigh value?

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