Internal medicine residents' perceptions of the Mini-Clinical Evaluation Exercise

Med Teach. 2008;30(4):414-9. doi: 10.1080/01421590801946962.


Background: The mini-clinical evaluation exercise (mini-CEX) is a 30 minute observed clinical encounter which allows assessment of a resident's clinical competence with feedback on their performance.

Aims: To assess residents' perceptions of the mini-CEX using qualitative methods.

Methods: After introducing the mini-CEX into the University of British Columbia's Internal Medicine Residency Program, a one hour semi-structured focus group with voluntary first and second year residents was undertaken. The focus groups were conducted by an independent moderator, audio-taped, and transcribed verbatim. Using a phenomenological approach, the comments made by the focus group participants were read independently by the three authors and organized into major themes.

Results: The major themes included Education, Assessment and Exam Preparation. Residents described a conflict between the mini-CEX's role as a method of assessment and its utility as an educational tool. During initial mini-CEX encounters, they perceived the assessment format as anxiety-provoking. Over time, they felt that the mini-CEX provided insight into their clinical competence. Participants believed that the mini-CEX experience would benefit them in preparation and successful completion of their national specialty exam.

Conclusions: Residents' perceptions of the mini-CEX reflected a tension between the tool's dual roles of assessment and education.

MeSH terms

  • British Columbia
  • Clinical Competence / standards*
  • Education, Medical, Undergraduate
  • Educational Measurement / methods*
  • Feedback
  • Focus Groups
  • Humans
  • Internal Medicine / education*
  • Internship and Residency*
  • Observation
  • Students, Medical / psychology*