Feasibility,Reliability and User Satisfaction With a PDA-Based Mini-CEX to Evaluate the Clinical Skills of Third-Year Medical Students |
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Authors: | Dario M. Torre Deborah E. Simpson D. Michael Elnicki James L. Sebastian Eric S. Holmboe |
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Affiliation: | 1. General Internal Medicine , Medical College of Wisconsin , Milwaukee, Wisconsin, USA;2. Family Medicine , Medical College of Wisconsin , Milwaukee, Wisconsin, USA;3. Department of Medicine , University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania, USA;4. Evaluation and Research, American Board of Internal Medicine , Philadelphia, Pennsylvania, USA |
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Abstract: | Background: The mini-clinical evaluation exercise (mini-CEX) has been used to assess clinical skills of 3rd-year medical schools. However a PDA-based mini-CEX has not been developed or evaluated before. Our objective was to determine the feasibility, implementation, and user satisfaction with a PDA-based mini-CEX. Description: Third-year medical students at the Medical College of Wisconsin who rotated on their core clinical clerkship in internal medicine during the period of July 2004 to April 2005 (n = 177) were required to complete two PDA-based mini-CEXs that were supervised by a faculty member or senior resident. Descriptive statistics and sample t test with equal variances were performed to analyze PDA-based mini-CEX completion rates, satisfaction scores by overall user and by evaluator type. Evaluation: During the 10-month study period, 354 PDA-based mini-CEX forms were collected (100% completion rate). Seventy-five percent (n = 267) of mini-CEXs occurred in the inpatient setting and 24% (n = 87) in the outpatient clinics. Students reported receiving feedback from their evaluator in 96% of these exercises. The most frequently evaluated competencies were humanism (90%), physical examination (90%), and overall clinical competence (90%). Third-year students were evaluated by residents in 58% (n = 205) of encounters and by faculty in 42% (n = 149). Residents rated students significantly higher than faculty (overall M = 7.6 vs. 7.1, respectively) in all clinical domains of the PDA-based form (p < .05). Satisfaction with the PDA-based mini-CEX was high (scale = 1–9) for residents (8.1; SD = 1.5), faculty (7.4; SD = 1.5), and students (8.0; SD = 1.7). Conclusions: A PDA-based mini-CEX is a feasible tool to facilitate the direct observation of students' clinical skills. The PDA-based mini-CEX was highly rated by students and evaluators as a valuable technology-based tool to document direct supervision of clinical skills. |
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