He Yanju, Wen Song, Zhou Mingyue, Li Xiucai, Gong Min, Zhou Ligang
Department of Endocrinology, Shanghai Pudong Hospital, Fudan University, Shanghai, 201399, People's Republic of China.
Helen Driller Family Comprehensive Cancer Center, University of California, San Francisco, CA, USA.
Diabetes Metab Syndr Obes. 2022 Jul 9;15:2031-2038. doi: 10.2147/DMSO.S372253. eCollection 2022.
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 department of endocrinology.
From January 2021 to January 2022, all rotating medical students at Shanghai Pudong Hospital completed two mini-CEX exams before and following their rotation under the supervision and guidance of six tutors. The mini-CEX form was modified in this study primarily for inpatient management based on our clinical experience and updated DM guidelines of the American Diabetes Association (ADA), the European Association for the Study of Diabetes (EASD), and the Chinese Diabetes Society (CDS). Each component of the mini-CEX assessment, including medical interviews, physical examination, clinical judgment, clinical management, and overall clinical competence was evaluated using a nine-item questionnaire.
Our findings revealed that the second-round performance on the assessments significantly improved, as indicated by higher scores on each component. The Pearson association analysis revealed that the feedback time of the first examination was markedly associated with improved overall scores (r= 0.391, p<0.001). However, no correlations were discovered between patient age, gender, disease severity disparity, or the interval between examinations (p>0.05). Additional regression analysis revealed that the feedback time during the initial examination was the most significant contributor to the increased overall scores (β=0.391, p<0.001).
This newly designed mini-CEX form based on current ADA and EASD guidelines may assist trainees in more effectively diagnosing and managing DM in inpatients, particularly those with macrovascular, microvascular, or peripheral nerve neuropathy. This study aims to assess the efficacy of administering a modified mini-CEX form to rotating trainees participating in an endocrine clerkship.
迷你临床评估演练（mini-CEX）是评估医学生在高强度临床实践中临床能力的优秀工具。在本研究中，Mini-CEX被改编为糖尿病（DM）专业问卷，并在内分泌科完成实习轮转的医学生中进行了测试。
2021年1月至2022年1月，上海浦东医院所有轮转医学生在6名带教老师的监督和指导下，在轮转前后各完成两次Mini-CEX考试。本研究中，Mini-CEX表格主要根据我们的临床经验以及美国糖尿病协会（ADA）、欧洲糖尿病研究协会（EASD）和中华医学会糖尿病学分会（CDS）更新的DM指南，针对住院患者管理进行了修改。Mini-CEX评估的每个组成部分，包括医学访谈、体格检查、临床判断、临床管理和整体临床能力，均使用一份9项问卷进行评估。
我们的研究结果显示，评估的第二轮表现有显著改善，各组成部分得分更高。Pearson相关性分析显示，第一次考试的反馈时间与整体得分的提高显著相关（r = 0.391，p < 0.001）。然而，未发现患者年龄、性别、疾病严重程度差异或两次考试间隔之间存在相关性（p > 0.05）。进一步的回归分析显示，初次考试期间的反馈时间是整体得分增加的最主要因素（β = 0.391，p < 0.001）。
这种基于当前ADA和EASD指南新设计的Mini-CEX表格可能有助于实习生更有效地诊断和管理住院患者的DM，特别是那些患有大血管、微血管或周围神经病变的患者。本研究旨在评估向参加内分泌科实习的轮转实习生发放改良版Mini-CEX表格的效果。
