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Increased scores on the mini-CEX in 5 domains including medical interview skills (A), physical examination skills (B), clinical judgment (C), clinical management skills (D), and overall clinical competence (E) as well as an increase in total scores (F) among rotating medical students before and after type 2 diabetes-specific training. N=79, ****P<0.0001.
Source publication
Background: The mini-clinical evaluation exercise (mini-CEX) is an excellent tool for assessing the clinical abilities of medical students in intense clinical practice. In this study, the Mini-CEX was adapted to professional questionnaires for Diabetes Mellitus (DM), and examined in medical students completing their clerkship rotation in the depart...
Context in source publication
Context 1
... expected, the scores for each domain on the mini-CEX form significantly increased when medical interviewing skills, physical examination skills, clinical judgment, medical management skills, overall clinical competencies, and total scores were evaluated (p<0.0001) (Figure 1). Correlational analyses of the increasing total score revealed that, in addition to the five components of primary assessment throughout training, the feedback time of the first examination is critical (p<0.001). ...
Citations
... This tool was used by more than 20 medical schools in the USA, and studies were conducted with good results; therefore, the ABIM examination was applied to evaluate the clinical skills of interns. 8 The mini-CEX is now widely used and has achieved effective results in many different countries, including the USA 10 and China, 11 and it represents an important way to develop and assess clinical practice skills as good evaluations have been received across medical master's students, resident doctors, new nurses and undergraduate nursing students. 12 13 Presently, domestic nursing scholars based on the mini-CEX conceptual framework and combined with clinical nursing work standards and clinical experience use a literature review and Delphi expert correspondence to compile the mini-CEX assessment scale, which is widely used in the field of clinical practice competence assessment for nursing trainees, regulatory nurses and new nurses. ...
Objective
To construct a scientific and systematic competency evaluation tool for master of nursing specialists (MNS) and to provide a reference for the training, assessment and competency evaluation of MNS.
Methods
A first draft of the indicators for assessing MNS core competencies was developed on the basis of published research and group discussions. Between June and December 2020, the indicators were revised using two rounds of the Delphi expert consultation method, with questionnaires completed by 16 experts from five provinces in China.
Results
The valid retrieval rate of the two questionnaires was 100.00%, and the coefficient of expert authority was 0.931. The Kendall’s concordance coefficients of the two rounds of questionnaires were 0.136 (p<0.05) and 0.147 (p<0.05), respectively. Consensus was reached on the seven dimensions and 52 items of the MNS competency assessment instrument. The instrument dimensions included nurse‒patient communication (9 items), health assessment (7 items), clinical decision-making (8 items), operational skills (7 items), health promotion (6 items), humanistic care (9 items) and organisational effectiveness (6 items).
Conclusions
The MNS competency assessment tool constructed in this study is focused and highly credible. The findings can be used as a guide for the training, assessment and competence evaluation of MNS in the future.
... Therefore, in recent years, there has been an increased robust contribution from the reform of medical undertakings and also emerges many clinical training and ability evaluation projects or classes, which our department is currently administering, such as the method of Mini-CEX, to train the students to grasp the insulin skills while their rotation under the monitoring of their senior doctors, and which could concurrently enhance the ability and responsibilities of their tutors. 17 Moreover, we could also observe the moderate change in recent years from the medical reform, with social and government focuses and support on improving the quality of the role of GP's "goal-keeper"; this crisis is already enduring melting. Now, the part of Endocrinologists at the central hospital can assist GPs in efficiently administering insulin therapy by providing the necessary resources and assistance. ...
Background
Despite the demonstrated benefits of insulin therapy, many general practitioners (GPs) are hesitant to administer it due to challenges such as a lack of knowledge, time constraints, and patient reluctance. The barriers that prevent a GP from initiating insulin therapy may vary in comparison to those encountered by a diabetic patient; this aspect of clinical research in the South Shanghai metropolitan area has received limited attention so far.
Objective
This is a 6-months of interventional analytic cohort study. The prime aim is to investigate the barriers general practitioners (GPs) face when initiating insulin therapy for patients with type 2 diabetes (T2D).
Materials and Methods
As part of a training program, all 189 registered GPs in Nanhui Health Service Center in Shanghai were given a structured online-multi-choice questionnaire before and after a six-month interval, during which the GPs received sessions of training on insulin therapy either on theoretic classes or clinical practices.
Results
Before and after training, via the methods of multiple-response analyses, the results showed that social, GP’s, and patient barriers to initiating insulin therapy were comparable. However, through the crosstabs chi-square test, we found significant changes in the basal insulin initiation following the prescription of the senior endocrinologists, the titration of insulin, and the need for training (p<0.05). The Spearman analyses discovered significant changes associated with the cause of initial insulin refusal and the factors influencing insulin administration. Finally, the binary logistic regression analysis revealed that distinct causes such as social factors, insurance, GP experience, insulin dosage calculation, follow-up, and patients’ feelings are related to insulin treatment application before and after training.
Conclusion
According to this study, training increased general practitioners’ confidence in initiating insulin administration, especially basal insulin. General practitioners require additional education on insulin therapy, with a potential need for increased face-to-face training for insulin initiation.
... There have been studies on mini-CEX implementation in other specialties, such as pediatrics, obstetrics and gynecology, cardiology, and endocrinology. 32,34,38,39 However, these studies did not highlight the limitations attributed to the lack of teachers' support. The critical parameter in these differences is faculty training prior to mini-CEX conduction. ...
Purpose
The Mini Clinical Evaluation Exercise (mini-CEX) is a brief and direct observational assessment of trainee-patient interactions that helps to assess several clinical domains. There is limited evidence of mini-CEX implementation in orthopedics and undergraduate perceptions toward such an approach. This study investigated the perception of mini-CEX among undergraduate medical students through a questionnaire-based survey in an orthopedic outpatient setting.
Patients and Methods
Undergraduate medical students completing their orthopedic clinical posting were invited to participate in an anonymous, self-administered questionnaire written in English to evaluate their perceptions toward mini-CEX implementation in the orthopedic outpatient setting for the 2016–2017 academic session. The questionnaire comprised 28 closed-ended questions with a five-point Likert rating-scale, and five open-ended questions. The survey responses were analyzed for reliability, validity, and quantitative and qualitative analyses.
Results
A total of 350 students completed the questionnaire; the questionnaire was proven to be valid and reliable. The closed-ended questions were designed to assess the knowledge of the mini-CEX as an assessment tool. The participants demonstrated a satisfactory understanding of the mini-CEX methodology, purpose, clarity, comprehensiveness, and as a self-assessment tool for undergraduate medical students. Instructor support for the implementation of mini-CEX appeared inadequate and was rated with non-confidence among most students. Most participants appreciated better clinical skills, which was reflected through improvements in clinical exam preparation, the Objective Structured Clinical Examination, and clinical judgment.
Conclusion
Undergraduate medical students perceived the mini-CEX as an effective tool for clinical teaching in an outpatient orthopedic setting. However, most students indicated suboptimal instructor involvement in the teaching and assessment process; this raises concerns regarding inadequate direct observation and limited feedback for student performance. Additional measures are needed to ensure high quality clinical encounters, teacher training, integration with other assessment tools, and standardized coverage mini-CEX implementation in orthopedics.
