Mini-CEX as a workplace-based assessment tool for interns in an emergency department--does cost outweigh value?

Med Teach. 2012;34(12):1017-23. doi: 10.3109/0142159X.2012.719653. Epub 2012 Oct 8.

Abstract

Background: The mini-clinical evaluation exercise (mini-CEX) has been proposed as a method to address the deficiencies of in-training assessment for junior doctors.

Aim: Our study aimed to determine the feasibility and value of adding mini-CEX assessments to the existing assessment processes for an intern cohort in the emergency department (ED).

Methods: Interns undertook four mini-CEX assessments with senior ED medical officers, in addition to their standard in-training assessment processes. Assessment results and time taken to perform the mini-CEX assessments were recorded. Interns and assessors completed a survey regarding their perceptions of the mini-CEX assessment process.

Results: The total time taken for mini-CEX assessments during the study period was 36.51 h. If extrapolated over a year this would represent an additional direct cost to the ED of more than $A 80,000 per year. No additional interns were identified as underperforming through the addition of the mini-CEX. The mini-CEX assessment process was perceived as generally positive. Both interns and assessors felt that it provided a valid assessment of intern performance, and enabled timely and specific feedback. Significant practical difficulties in arranging and conducting mini-CEX assessments in the workplace were identified.

Conclusion: There was a significant cost to the ED as a result of adding mini-CEX encounters to interns' performance assessment. No change in summative outcome occurred for this study cohort.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Checklist*
  • Emergency Service, Hospital*
  • Feasibility Studies
  • Hospitals, Teaching
  • Humans
  • Medical Staff, Hospital*
  • Program Evaluation / methods*
  • Queensland
  • Surveys and Questionnaires