Abstract
Three to 12 evaluations of clinical performance using the mini-clinical evaluation exercise (Mini-CEX) (n=124) or direct observation of procedural skills (DOPS) (n=21) were performed on 27 trainees working in an NHS neurology department. The communications/counselling skills subdomain was scored in 64 evaluations. For Mini-CEX the focus was on gathering data (22%), diagnosis (31%), management (34%) and counselling (7%) (focus not recorded in 6%). For DOPS, lumbar puncture was the most common evaluated procedure (57%). Mini-CEX evaluations lasted 23.8 minutes (10.6) (mean, sd) and DOPS 25.9 minutes (12.6). MiniCEX scores for overall competence and communication skills were mean 5.99 (sd 0.95, range 4–8) and 5.98 (sd 1.21, range 3–9) and for DOPS 5.71 (sd 0.90, range 4–8) both on scales of 1 to 9. Overall trainee competence and communication scores increased with year of training (p<0.001, p<0.004 univariate analysis). Assessors undertook up to three or four assessments in a session. Assessors and trainees considered that the observation and feedback had been ‘very’ or ‘quite’ useful in providing a relevant element of assessment. These assessments were feasible and useful in a neurology department and provided some evidence for increasing performance with trainee seniority. More assessor time (approximately one hour) than trainee time (24–26 min) was needed for each assessment undertaken.
KEY WORDS: direct observation of procedural skills, mini-clinical evaluation exercise, neurology, performance, trainees
Full Text
The Full Text of this article is available as a PDF (301.4 KB).