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用于评估医学研究生神经内科病例的迷你临床评估练习(Mini-CEX)

The Evaluation of Mini-Clinical Evaluation Exercise (Mini-CEX) for Assessing Neurology Cases Among Postgraduate Medicine Students.

作者信息

Khan Afreen, Jose Rosmy, Uddin Azhar, Islam Sajad Ul

机构信息

Internal Medicine, Hamdard Institute of Medical Sciences and Research, New Delhi, IND.

Community Medicine, Hamdard Institute of Medical Sciences and Research, New Delhi, IND.

出版信息

Cureus. 2024 Nov 13;16(11):e73641. doi: 10.7759/cureus.73641. eCollection 2024 Nov.

Abstract

Background Traditional assessments in postgraduate medical training tend to emphasize cognitive skills while often neglecting the psychomotor and affective domains. The mini-clinical evaluation exercise (mini-CEX) addresses these limitations by evaluating clinical, communication, and humanistic skills with immediate feedback. This study aimed to evaluate the acceptability and feasibility of the mini-CEX in assessing neurology cases among postgraduate internal medicine students at a medical college in North India. Methods Between March and July 2024, 10 postgraduate medicine students and 14 faculty members participated in the study. Each student completed at least four mini-CEX sessions, during which performance across seven core skills was rated using a nine-point scale. Immediate feedback was provided by faculty following each session. Both student and faculty feedback were collected to assess the acceptability and feasibility of the mini-CEX. Descriptive statistics were used to evaluate these factors, while paired t-tests were applied to measure improvements in student performance. Results A total of 63 mini-CEX sessions were conducted, with an average observation time of 18.77 minutes and an average feedback time of 10.08 minutes. Significant improvements in clinical skills were observed among second-year (P = 0.04) and third-year (P = 0.01) residents, with second-year residents also showing gains in humanistic skills (P = 0.03). Student feedback was largely positive, with nine out of 10 (90%) participants expressing satisfaction and eight out of 10 (80%) recommending the continued use of the tool. Faculty feedback indicated that 10 of 14 (71.4%) supported its continued use and eight of 14 (57%) found it better than traditional assessment methods. Conclusions The mini-CEX is a feasible and acceptable formative assessment tool for neurology cases, effectively enhancing clinical and communication skills. Despite concerns regarding subjectivity, the mini-CEX shows promise for wider implementation in postgraduate, and potentially undergraduate, medical training.

摘要

背景

研究生医学培训中的传统评估往往侧重于认知技能,而常常忽视心理运动和情感领域。迷你临床评估练习(mini-CEX)通过评估临床、沟通和人文技能并提供即时反馈来解决这些局限性。本研究旨在评估mini-CEX在印度北部一所医学院的研究生内科学生中评估神经病例的可接受性和可行性。方法:在2024年3月至7月期间,10名研究生医学学生和14名教员参与了该研究。每名学生至少完成了四次mini-CEX课程,在此期间,使用九点量表对七项核心技能的表现进行评分。每次课程后教员都会提供即时反馈。收集学生和教员的反馈以评估mini-CEX的可接受性和可行性。使用描述性统计来评估这些因素,同时应用配对t检验来衡量学生表现的提高。结果:共进行了63次mini-CEX课程,平均观察时间为18.77分钟,平均反馈时间为10.08分钟。在二年级(P = 0.04)和三年级(P = 0.01)住院医师中观察到临床技能有显著提高,二年级住院医师在人文技能方面也有提高(P = 0.03)。学生反馈大多是积极的,10名参与者中有9名(90%)表示满意,10名中有8名(80%)建议继续使用该工具。教员反馈表明,14名中有10名(71.4%)支持继续使用,14名中有8名(57%)认为它比传统评估方法更好。结论:mini-CEX是一种用于神经病例的可行且可接受的形成性评估工具,能有效提高临床和沟通技能。尽管存在主观性问题,但mini-CEX有望在研究生以及可能的本科医学培训中得到更广泛的应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51a3/11645463/fe1ec9598688/cureus-0016-00000073641-i01.jpg

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