Chinese doctors’ views on workplace-based assessment: trainee and supervisor perspectives of the mini-CEX

Yuying Liang,Lorraine M Noble

doi:10.1080/10872981.2020.1869393

Yuying Liang, Lorraine M Noble

Open Access

https://doi.org/10.1080/10872981.2020.1869393

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Abstract

ABSTRACT Purpose: This study investigated whether the mini-clinical evaluation exercise (mini-CEX) has been successfully integrated into the Chinese context, following its introduction as part of the national general training programme. Materials and methods: Online questionnaires (N = 91) and interviews (N = 22) were conducted with Year 1 trainee doctors and clinical supervisors at a cancer hospital in China to explore users’ experiences, attitudes and opinions of the mini-CEX. Results” Trainees were more likely than supervisors to report understanding the purpose of the mini-CEX and agree that it encouraged reflection and helped improve overall performance. Both trainees and supervisors felt that it provided a framework for learning, that it was useful in identifying underperformance, and that it informed learning progression. Groups were equally positive about the commitment of their counterpart in the process and valued the focus on detailed feedback. It was perceived as cultivating the learner–teacher relationship. Overall, both groups felt they ‘bought in’ to using the mini-CEX. However, concerns were raised about subjectivity of ratings and lack of benchmarking with expected standards of care. Conclusions: Chinese trainees and supervisors generally perceived the mini-CEX as an acceptable and valuable medical training tool, although both groups suggested enhancements to improve its efficacy.

Highlights

The nationwide implementation of the StandardisedResident Training Program in 2017 [1], introduced a range of workplace-based assessments (WBAs) intoChinese postgraduate medical education [2]
‘mini-CEX’ is one such assessment [3,4], involving direct observation of a trainee-patient encounter, with ratings and feedback given by the supervisor across domains such as
Trainees were more likely to report a clear understanding of the purpose of the mini-CEX

Summary

Introduction

The nationwide implementation of the StandardisedResident Training Program in 2017 [1], introduced a range of workplace-based assessments (WBAs) intoChinese postgraduate medical education [2]. The ‘mini-CEX’ (mini clinical evaluation exercise) is one such assessment [3,4], involving direct observation of a trainee-patient encounter, with ratings and feedback given by the supervisor across domains such as ‘history-taking’, physical examination, communication, clinical judgement, professionalism and organisation. The mini-CEX has positive educational value in clinical training [7,8], but outcomes can be constrained by trainee and supervisor knowledge and attitudes [9]. Acceptance of the mini-CEX differs among users [10,11], but few studies have examined concordance of trainee and supervisor perspectives [12,13]. The acceptability of educational innovation may determine the utility of the miniCEX in new cultural contexts [14,15].

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Conclusion