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Mini-CEXs as a Supplement to the Objective Structured
Clinical Examination (OSCE) Score
Authors: Glenn Robertson and Joan A Fraser
Department of Pediatrics, University of British Columbia
The mini-clinical evaluation exercise (mini-CEX) was developed by the American
Board of Internal Medicine as a tool for evaluating residents at the post-graduate
training level. Many undergraduate programs including internal medicine,
surgery and pediatrics have modified the mini-CEX; allowing faculty to assess
the history taking and clinical examination skills of medical students. We
have modified the mini-CEX to cover three additional competencies in addition
to history taking and clinical examination skills. These are: counseling
skills (giving of information), the case presentation (presentation skills)
and clinical reasoning skills. Students were initially required to complete
four mini-CEXs during their eight- week pediatric rotation; this number has
been increased to eight, allowing all five competencies to be evaluated.
The student's score from their eight mini-CEXs is included as a portion of their
objective structured clinical examination (OSCE) score. Similar to the
OSCE, students are observed during each mini-CEX, however, the mini-CEX
allows this to be done with a real patient or educational encounter. The students
receive the benefit of instant feedback with the mini-CEX.Additionally,
since the students must complete these eight tasks over eight weeks, students
with difficulties can be identified early and specific supplemental support
may be implemented. Given the increasing difficulty with finding standardized
patients for OSCE examinations the mini-CEXs may supplement and perhaps replace
the use of the OSCE as a clinical skills assessment tool.
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