Faculty Development: Mini-CEX as Workplace-Based Assessment

Background: Competence-based curriculum has become the need of medical education to meet theobjectives of institutions aiming to produce skilled physicians. To achieve the optimal competenceand performance of graduates a number of traditional evaluation exercises have been practiced.Some of these e.g. OSCE although meet the acceptable standard of reliability and validity is theassessment done in a controlled environment. This leaves the room for performance-basedassessment in real clinical situation such as mini clinical evaluation exercise (Mini-CEX). To practiceand meet the challenges of Mini-CEX it is vital to undertake faculty development program with acomprehensively chalked down Mini-CEX protocol and its objectives to achieve the intendedoutcome.Objective: To undertake faculty development on Mini-CEX for its feasibility and acceptability as amethod of formative assessment to evaluate the clinical competence of trainees in postgraduateprogram of Otolaryngology and Head-Neck Surgery.Method: 25 trainees from the four classes of master of surgery program of 2009 in Otolaryngologyand Head-Neck Surgery (ORL-HNS) undertook Mini-CEX encounters and assessed by 9 supervisors in a12-week period of study. Faculty development program was carried out through prior lecturesdeliberating on background, concept and procedure of Mini-CEX followed by demonstrations usingvideo clip of Mini-CEX encounter recorded in own clinical environment. Students were also exposedto similar settings to take up the Mini-CEX encounter without any hesitation. Trainees were assessedin outpatient clinical setting. Program was evaluated for its feasibility and acceptability with respectto patient’s factors, clinical attributes, supervisor and trainee’s performance and their reported levelof satisfaction.Result: Faculty development and trainees orientation in Min-CEX was achieved as feasible andacceptable. Higher rating of satisfaction was reported by majority assessors and trainees as theyfound Mini-CEX acceptable for formative assessment. Among clinical skills highest rating wasreceived in physical examination and lowest rating in therapeutic skills.Conclusion: A motivated faculty and organized approach towards a comprehensive knowledge onMini-CEX for its background communication, demonstration of procedure and method to completethe rating forms is the useful guide to adopt Mini-CEX. The faculty and trainees in department of ORLHNSfound Mini-CEX as feasible and acceptable assessment tool to monitor educational activity ofpostgraduate program through performance-based evaluation in a real clinical situation.