La utilización del Mini Clinical Evaluation Exercise (mini-CEX) en estudiantes de medicina

Abstract

espanolEn los ultimos anos se recomienda el uso de instrumentos que evaluen la adquisicion de habilidades clinicas en el contexto de la practica clinica. Entre los instrumentos mas recomendados se encuentra el Mini Clinical Evaluation Exercise (mini-CEX), desarrollado inicialmente para la evaluacion de medicos residentes, y que ha demostrado una buena fiabilidad y validez. Aunque se ha utilizado en estudiantes de medicina, no se dispone de un analisis completo de la experiencia acumulada. Para la presente revision se realizo en septiembre de 2014 la busqueda de los articulos indizados en Medline, Embase, Biosis Previews y Current Contents. Se seleccionaron aquellos articulos que incluian los terminos ‘mini clinical evaluation exercise’, ‘mini-CEX’ o ‘mcex’. Tras la eliminacion de los duplicados se obtuvo un total de 168 articulos. Se revisaron los que se referian al uso del mini-CEX en estudiantes de medicina (n = 34) y se analizaron a fondo aquellos que contenian datos empiricos (n = 21). Los estudios llevados a cabo en estudiantes de medicina confi rman que el mini-CEX es un instrumento util y factible para evaluar las habilidades clinicas de los estudiantes de medicina y que posee propiedades psicometricas adecuadas en terminos de validez y fi abilidad. Asimismo, es bien aceptado por estudiantes y tutores y puede ser usado tanto con fi nalidades formativas como sumativas. La importancia de dar un feedback adecuado y la concordancia de las puntuaciones de los tutores son los puntos mas criticos en la implementacion del mini-CEX en estudiantes de grado. EnglishIn recent years the use of work-based assessments has been increasingly recommended to evaluate clinical skills, as they allow for the evaluation of performance in the context of clinical practice. Among these tools, one of the most recommended is the Mini Clinical Evaluation Exercise (mini-CEX). This method was developed to be used in physicians-in-training and has good reliability and validity properties. Even when mini-CEX has also been used in medical students, a review of its value in undergraduates is lacking. This review is mainly based on a search of the articles indexed in Medline, Embase, Biosis Previews or Current Contents databases in September 2014. References were selected for articles which included the following terms: ‘mini clinical evaluation exercise’, ‘mini-CEX’ or ‘mcex’. Duplicates between databases were eliminated; as a result, a total of 168 articles were retrieved. Articles that dealt with the use of mini-CEX in medical students were reviewed (n = 34) and those that included empirical data were further analysed (n = 21). These studies confirm that this tool is useful and feasible to assess medical students and has adequate psychometric properties in different domains of validity and reliability. It is also well-accepted by students and tutors and may be used both in formative and summative evaluations. The present review shows that mini-CEX is also a good tool to assess clinical skills of medical students. The importance of giving adequate feedback and the alignment in the scores of tutors are the most critical points to be considered in the implementation of mini-CEX in undergraduate students.