Abstract

BackgroundOne of the most frequently used assessment tools that measure the trainees’ performance in workplace is the mini-Clinical Evaluation Exercise (mini-CEX), in which an expert observes and rates the actual performance of trainees. Several primary studies have evaluated the effectiveness of mini-CEX by assessing its educational and psychometric properties. The objective of this BEME review is to explore, analyze, and synthesize the evidence considering the utility of the mini-CEX for assessing undergraduate and postgraduate medical trainees.MethodsStudies reporting on mini-CEX performed in undergraduate and postgraduate medical education and providing some empirical data for mini-CEX in relation to one or more of the validity, reliability, educational impact, acceptability, and cost of mini-CEX will be included in the review. No restrictions on study design or publication date or language will be handled. To ensure comprehensiveness of our search, we will use different approaches and methods. In addition to electronic search in bibliographic databases, we will conduct forward and backward searching. We will also contact leading authors in the field of mini-CEX and will search for the gray literature. Data extractions will be done independently by two coders based on a form. If there is any discordance, a third author will resolve it.The quality assessment will be also done independently by two team members, based on critical appraisal checklists. In attempting to answer our original research questions, we will use meta-analysis or meta-synthesis.DiscussionThe findings of this study can be transferred to the medical education stakeholders such as administrators of medical schools, residency program directors, and faculty members.We also hope that publication of this review will encourage stakeholders who have already adopted the mini-CEX to evaluate and report its different characteristics. Lastly, we expect that we can identify gap of knowledge in this field and suggest areas for future research.

Highlights

  • One of the most frequently used assessment tools that measure the trainees’ performance in workplace is the mini-Clinical Evaluation Exercise, in which an expert observes and rates the actual performance of trainees

  • The studies varied in several other aspects: either original or modified version of the mini-CEX form has been used in different studies; the tool has been used for different purposes; different numbers of encounters have been considered adequate; raters have been different; the length of rotation in which mini-CEX was used varied; various numbers of forms have been filled for each learner; and different outcomes have been evaluated

  • We found a number of systematic reviews that have tackled the issue of workplace-based assessment (WPBA) tools

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Summary

Methods

Objectives, and keywords The main objective of this Best Evidence Medical Education (BEME) review is to explore, analyze, and synthesize the evidence considering the utility of the mini-CEX for assessing undergraduate and postgraduate medical trainees. Studies reporting on mini-CEX performed in undergraduate and postgraduate medical education and providing some empirical data for mini-CEX in relation to one or more of the validity, reliability, educational impact, acceptability, and cost of mini-CEX will be included in the review. According to the fact that less than 500 studies were found in our scoping search, we assumed that including population (i.e., undergraduate and postgraduate medical trainees), together with study outcomes (reliability, validity, etc.), would diminish the sensitivity of search strategy and limit the number of retrieved articles even further. Frequency Summative Validity Reliability Educational Acceptability Cost Study name date undergraduate size characteristics of use or formative impact quality trainees purposes discordance, since it is possible that the source of the disagreement is an error by one side, in the first place, the coders will be asked to discuss the issue.

Discussion
Background
11. Triangulation
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