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.