Internal medicine residents’ perceptions of the Mini-Clinical Evaluation Exercise

Abstract

Background: The mini-clinical evaluation exercise (mini-CEX) is a 30 minute observed clinical encounter which allows assessment of a resident's clinical competence with feedback on their performance.

Aims: To assess residents’ perceptions of the mini-CEX using qualitative methods.

Methods: After introducing the mini-CEX into the University of British Columbia's Internal Medicine Residency Program, a one hour semi-structured focus group with voluntary first and second year residents was undertaken. The focus groups were conducted by an independent moderator, audio-taped, and transcribed verbatim.

Using a phenomenological approach, the comments made by the focus group participants were read independently by the three authors and organized into major themes.

Results: The major themes included Education, Assessment and Exam Preparation. Residents described a conflict between the mini-CEX's role as a method of assessment and its utility as an educational tool. During initial mini-CEX encounters, they perceived the assessment format as anxiety-provoking. Over time, they felt that the mini-CEX provided insight into their clinical competence. Participants believed that the mini-CEX experience would benefit them in preparation and successful completion of their national specialty exam.

Conclusions: Residents’ perceptions of the mini-CEX reflected a tension between the tool's dual roles of assessment and education.

Additional information

Notes on contributors

Samir Malhotra

DR MALHOTRA was a chief medical resident at the time of this research with the University of British Columbia, Department of Medicine.

Rose Hatala

DR HATALA is a general internist and clinical associate professor, Department of Medicine, University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada. She was an associate program director for the internal medicine residency program at the time of this research.

Carol-Ann Courneya

DR COURNEYA is an Associate Professor and Medical Educator in the Faculty of Medicine at the University of British Columbia.