Sara Mortaz Hejri1, Mohammad Jalili1,2, Rasoul Masoomi1, Mandana Shirazi1,3, Saharnaz Nedjat4, John Norcini5. 1. Department of Medical Education, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2. Department of Emergency Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 3. Department of Clinical Science and Education at SOS Hospital, Karolina Institute, Stockholm, Sweden. 4. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. 5. Foundation for Advancement of International Medical Education and Research (FAIMER), Philadelphia, PA, USA.
Abstract
Background: This BEME review aims at exploring, analyzing, and synthesizing the evidence considering the utility of the mini-CEX for assessing undergraduate and postgraduate medical trainees, specifically as it relates to reliability, validity, educational impact, acceptability, and cost. Methods: This registered BEME review applied a systematic search strategy in seven databases to identify studies on validity, reliability, educational impact, acceptability, or cost of the mini-CEX. Data extraction and quality assessment were carried out by two authors. Discrepancies were resolved by a third reviewer. Descriptive synthesis was mainly used to address the review questions. A meta-analysis was performed for Cronbach's alpha. Results: Fifty-eight papers were included. Only two studies evaluated all five utility criteria. Forty-seven (81%) of the included studies met seven or more of the quality criteria. Cronbach's alpha ranged from 0.58 to 0.97 (weighted mean = 0.90). Reported G coefficients, Standard error of measurement, and confidence interval were diverse and varied based on the number of encounters and the nested or crossed design of the study. The calculated number of encounters needed for a desirable G coefficient also varied greatly. Content coverage was reported satisfactory in several studies. Mini-CEX discriminated between various levels of competency. Factor analyses revealed a single dimension. The six competencies showed high levels of correlation with statistical significance with the overall competence. Moderate to high correlations between mini-CEX scores and other clinical exams were reported. The mini-CEX improved students' performance in other examinations. By providing a framework for structured observation and feedback, the mini-CEX exerts a favorable educational impact. Included studies revealed that feedback was provided in most encounters but its quality was questionable. The completion rates were generally above 50%. Feasibility and high satisfaction were reported. Conclusion: The mini-CEX has reasonable validity, reliability, and educational impact. Acceptability and feasibility should be interpreted given the required number of encounters.
Background: This BEME review aims at exploring, analyzing, and synthesizing the evidence considering the utility of the mini-CEX for assessing undergraduate and postgraduate medical trainees, specifically as it relates to reliability, validity, educational impact, acceptability, and cost. Methods: This registered BEME review applied a systematic search strategy in seven databases to identify studies on validity, reliability, educational impact, acceptability, or cost of the mini-CEX. Data extraction and quality assessment were carried out by two authors. Discrepancies were resolved by a third reviewer. Descriptive synthesis was mainly used to address the review questions. A meta-analysis was performed for Cronbach's alpha. Results: Fifty-eight papers were included. Only two studies evaluated all five utility criteria. Forty-seven (81%) of the included studies met seven or more of the quality criteria. Cronbach's alpha ranged from 0.58 to 0.97 (weighted mean = 0.90). Reported G coefficients, Standard error of measurement, and confidence interval were diverse and varied based on the number of encounters and the nested or crossed design of the study. The calculated number of encounters needed for a desirable G coefficient also varied greatly. Content coverage was reported satisfactory in several studies. Mini-CEX discriminated between various levels of competency. Factor analyses revealed a single dimension. The six competencies showed high levels of correlation with statistical significance with the overall competence. Moderate to high correlations between mini-CEX scores and other clinical exams were reported. The mini-CEX improved students' performance in other examinations. By providing a framework for structured observation and feedback, the mini-CEX exerts a favorable educational impact. Included studies revealed that feedback was provided in most encounters but its quality was questionable. The completion rates were generally above 50%. Feasibility and high satisfaction were reported. Conclusion: The mini-CEX has reasonable validity, reliability, and educational impact. Acceptability and feasibility should be interpreted given the required number of encounters.
Authors: Catharina M Haring; Claudia C R Klaarwater; Geert A Bouwmans; Bernadette M Cools; Petra J M van Gurp; Jos W M van der Meer; Cornelis T Postma Journal: BMC Med Educ Date: 2020-06-19 Impact factor: 2.463
Authors: Flora P Gittinger; Martin Lemos; Jan L Neumann; Jürgen Förster; Daniel Dohmen; Birgit Berke; Anke Olmeo; Gisela Lucas; Stephan M Jonas Journal: BMC Med Educ Date: 2022-03-16 Impact factor: 2.463