Assessment of clinical competence in a pediatric residency with the Mini-Clinical Evaluation Exercise (Mini-CEX)

PURPOSEAssess the clinical competence of pediatric residents with the implementation of Mini-Clinical Evaluation Exercise (Mini-CEX), determining its validity, reliability, feasibility and satisfaction of examiners and residents. METHODS14 examiners and 8 residents of pediatrics took part. The Mini-CEX, a method based on direct observation of residents during their daily training, was used. A nine-point rating scale was used in order to evaluate their skills regarding medical interviewing, physical examination, professionalism, clinical judgment, counselling, organization, overall competence and satisfaction with the method. RESULTS181 observations were made, an average of 12.92 observations per examiner (range-2-39). Each examiner assessed 5.78 residents, (range 2-8). There was an average of 22.6 assessments per resident, range (18-30). The observations took place in outpatient clinic 38.7%, pediatric inpatient unit 19.3%, neonatal intensive care unit 17.1%, neonatal reception unit 14.4% and rooming-in 10.5%. The mean scores were: professionalism 7.15; interviewing 6.64; physical examination 6.67; clinical judgment 6.70; counselling 6.79 and organization 6.73. The overall competence score varied according to experience levels. Mean scores were: first-year residents 6.57; second-year residents 6.87 and third-year residents 7.3; p= 0.004. The score related to examiners's satisfaction was 7.89 and that of the residents was 7.74. The duration of the observation period was 28.35 minutes. Cronbach alfa coefficient was 0.97 showing the high reliability of the assessment method. The ANOVA score for overall competence of all examiners showed statistically significant differences, p