Effectiveness of Mini-Clinical Evaluation Exercise (Mini-Cex) as a Formative Assessment Tool for Mbbs Students During Short-Term Respiratory Medicine Posting

Abstract

Background: Short undergraduate clinical postings may limit opportunities for direct observation of clinical skills and individualised feedback. The mini-clinical evaluation exercise (Mini-CEX) offers a structured approach to workplace-based formative assessment. The study was undertaken to evaluate changes in clinical performance scores between two Mini-CEX encounters and assess student and faculty perceptions of its educational value and feasibility during a short-term respiratory medicine posting.

Methods:  Final professional MBBS students underwent an initial Mini-CEX assessment following structured clinical teaching, received feedback and targeted teaching, and subsequently underwent reassessment using a different patient encounter. Six competency domains were rated on a nine-point scale, and overall clinical competence was assessed separately. Paired scores were compared using a paired t-test for the composite outcome and the Wilcoxon signed-rank test for individual domains. Student and faculty perceptions were assessed using structured questionnaires.

Results: Ninety-four paired Mini-CEX assessment sets were analysed. Mean scores increased across all six competency domains, with mean differences ranging from 0.39 points for medical interviewing to 0.59 points for organisation and efficiency. Overall clinical competence scores increased from 4.79 ± 0.95 to 5.25 ± 1.36 (p = 0.004). Student perceptions were predominantly favourable, with agreement or strong agreement ranging from 90.4% to 96.8% across the six questionnaire statements. All four faculty respondents supported continuation of Mini-CEX, and all considered feedback discussions useful for student learning.

Conclusion: Mini-CEX was feasible to implement during a short undergraduate respiratory medicine posting and was associated with higher observed clinical performance scores at reassessment, alongside favourable student and faculty perceptions.