Assessing the mini-Clinical Evaluation Exercise in comparison to a national specialty examination

Purpose To evaluate the reliability and validity of the Mini‐Clinical Evaluation Exercise (mini‐CEX) for postgraduate year 4 (PGY‐4) internal medicine trainees compared to a high‐stakes assessment of clinical competence, the Royal College of Physicians and Surgeons of Canada Comprehensive Examination in Internal Medicine (RCPSC IM examination). Methods Twenty‐two PGY‐4 residents at the University of British Columbia and the University of Calgary were evaluated, during the 6 months preceding their 2004 RCPSC IM examination, with a mean of 5.5 mini‐CEX encounters (range 3–6). Experienced Royal College examiners from each site travelled to the alternate university to assess the encounters. Results The mini‐CEX encounters assessed a broad range of internal medicine patient problems. The inter‐encounter reliability for the residents' mean mini‐CEX overall clinical competence score was 0.74. The attenuated correlation between residents' mini‐CEX overall clinical competence score and their 2004 RCPSC IM oral examination score was 0.59 (P = 0.01). Conclusion By examining multiple sources of validity evidence, this study suggests that the mini‐CEX provides a reliable and valid assessment of clinical competence for PGY‐4 trainees in internal medicine.