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The mini-CEX and you!

The mini-CEX and you!. Simon Field MD CCFP(EM) FCFP M.Ed Assistant Dean, Clerkship Dalhousie Undergraduate Medical Education Dec 13, 2013. Recording warning.

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The mini-CEX and you!

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  1. The mini-CEX and you! Simon Field MD CCFP(EM) FCFP M.Ed Assistant Dean, Clerkship Dalhousie Undergraduate Medical Education Dec 13, 2013

  2. Recording warning This session is being recording.   If you do not wish to be recorded, please feel free to leave the session and you can receive a copy of the recording  through the Faculty Development office.

  3. Please Note: • This session is being recorded for distribution to faculty unable to attend in person. Please contact facdev@dal.ca if you have questions or concerns about this. • Please sign the attendance form to obtain CME credit. • To obtain a summary of your CME credits for 2013, contact facdev@dal.ca.

  4. Disclosure The presenter has no real or perceived conflicts of interests

  5. Objectives After this session participants will: • Have defined the concept of and reviewed evidence for the mini Clinical Examination Exercise (CEX) • Have reviewed the rationale for initiation of mini-CEX within the Skilled Clinician program at Dalhousie • Have understanding of the methodology and scoring for direct observation of clinical encounters

  6. What is a mini-CEX? • Brief • Observed • Focused • Formative • Accompanied by feedback • Variety of settings

  7. What is the evidence? • Widely used in US, UK, Australia/NZ, Canada • Spectrum from students to postgrad to CPD • Involves clinical performance on real patients plus feedback and reflection “The mini-CEX assesses residents in a much broader range of clinical situations … has better reproducibility…offers residents greater opportunity for observation and feedback by more than one faculty member and with more than one patient “ Norcini et al. Ann Int Med: Nov 1995 123(10)

  8. Why mini-CEX at Dalhousie? • Pre-clinical training uses simulated patients (SPs) extensively • Minimal use of real patients • Main clinical assessment tools are ITERs • “Failure to fail” • Minimal observation of performance • Students respond well to feedback

  9. How does it fit in? • Skilled Clinician Program • “Clinical Skills” in Med 1 and 2 • Expansion into Med 3 • Final portfolio in Med 4

  10. How does it work at Dalhousie? • Broad range of evaluators – interprofessional, trainees • 10-15 minutes observation • Focused on pre-determined domain • Standardized form completed • Feedback given (approx 5 minutes)

  11. How does it work at Dalhousie? (continued) • Complete one per 3-week rotation • Add to student portfolio • Complete 15 over the course of 3rd year • Student selects “best 5” • Portfolio reviewed by UGME to ensure completion • Intent is to witness progression in skills development

  12. What isn’t it… • NOT an ITER! • NOT summative • NOT a “convenience” item

  13. What are the Domains to be assessed? Select One Domain of: Assess Every Time: Professionalism Organization/efficiency Overall competence • History taking • Physical examination • Communication skills • Patient Counseling • Clinical Reasoning

  14. How to do it… • Discuss the exercise prior to observing the encounter • Give meaningful feedback that the student can use in the future • Use specific examples • Obtain clarification from the learner and encourage reflection

  15. Scoring the mini-CEX

  16. Scoring (cont)

  17. Resources http://facdev.medicine.dal.ca/tech-enhance.php

  18. Questions? SimonField@Dal.ca

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