Mini-Clinical Evaluation Exercise

Introduction

The Mini-Clinical Evaluation Exercise is a RANZCP-approved Workplace-based Assessment (WBA) tool. The purpose of this tool is to promote learning for trainees by providing structured feedback on performance within an authentic workplace context.

What is a Mini-CEX?

A Mini-Clinical Evaluation Exercise is a concise, validated method of assessment consisting of a supervisor observing a trainee during a consultation with a real patient and providing feedback to the trainee about their performance. The most important part of the Mini-Clinical Evaluation Exercise is the feedback given to the trainee.

Mini-Clinical Evaluation Exercises, like all WBAs, should contribute to the evidence base that informs a supervisor’s judgement as to whether a trainee can be entrusted with a particular Entrustable Professional Activity (EPA) and/or for the mid-rotation In-Training Assessment (ITA) Form and end-of-rotation ITA Report.

Forms and documents

You should complete the Mini-CEX form via Intrain. If you do not have access to Intrain, use the PDF form.

Mini-Clinical Evaluation Exercise form [PDF; 572 KB]

Choosing an encounter

The patient, who has agreed to participate, should either be selected by the supervisor so that it is a new patient for the trainee, or the trainee should undertake a new task with a patient to fulfil the Mini-Clinical Evaluation Exercise.

Assessments should be chosen over a range of clinical activities and settings.

Supervision

The supervisor must be familiar with the Mini-Clinical Evaluation Exercise assessment process.

• Supervisors must be clinically competent in the area of psychiatry being assessed.

A Mini-Clinical Evaluation Exercise can be conducted during regular supervision time in an appropriate office or working space that lends itself to privacy.

Assessment criteria

The aim of the Mini-Clinical Evaluation Exercise is to enable supervisors to provide structured feedback across the following areas:

• history-taking process

• history-taking content

• mental state examination skills

• physical examination skills

• communication skills

• data synthesis

• organisation/efficiency.

Prior to conducting each Mini-Clinical Evaluation Exercise, the trainee and supervisor should determine together which of the assessment criteria to focus on during the formative assessment. The feedback should focus on the agreed specific clinical tasks rather than on the trainee’s general performance.

How to undertake a Mini-Clinical Evaluation Exercise

The trainee is responsible for planning when a Mini-Clinical Evaluation Exercise will occur in consultation with the supervisor.

1. The trainee makes arrangements with a supervisor to carry out a Mini-Clinical Evaluation Exercise on an appropriate patient and organises all administration required (including providing the supervisor with the Mini-Clinical Evaluation Exercise form).

2. The trainee and supervisor determine the assessment criteria to be considered during the Mini- Clinical Evaluation Exercise.

3. The supervisor observes the trainee during a consultation with a patient.

   • The supervisor should not participate in the consultation unless intervention is required for the patient’s safety.

   • This consultation should typically take 15–20 minutes.

4. The feedback session occurs immediately after the consultation within the 1-hour weekly supervision time.

   • The feedback should be constructive and address: areas that were especially good, suggestions for improvement, agreed actions and goals.

   • The total time required for the Mini-Clinical Evaluation Exercise and feedback session will usually be 30–40 minutes.

5. The supervisor rates the trainee’s performance for the relevant assessment criteria using the 3- point scale on the Mini-Clinical Evaluation Exercise form.

   • The cumulative weight of the feedback comments and ratings helps determine a defensible judgement of a trainee’s competence at their stage of training.

   • Please note that not all assessment criteria on the form are required to be rated during each Mini-Clinical Evaluation Exercise. Not applicable criteria are rated with the N/A option.

Table 1 Standard guide for rating scale

see Developmental Descriptors document for more detail

Please note: standards are at the level expected on completion of the relevant stage of training. CbDs conducted at the beginning of a stage may typically include ratings of below ‘Meets standard for the end of stage’. This approach highlights areas for improvement and allows trainees to view their progress along a continuum.

6. The trainee and supervisor discuss and agree upon the next steps to progress learning. Both the supervisor and trainee sign the Mini-Clinical Evaluation Exercise form.

7. The trainee is required to maintain a portfolio of their Fellowship Program forms, including their WBA forms. Trainees are required to provide this portfolio to their next supervisor for review at the start of each new rotation.

Feedback

The feedback given after a Mini-Clinical Evaluation Exercise is important. Constructive and useful feedback should be given to the trainee on:

• areas that were especially good

• areas that need improvement

• potential ideas to gain further experience and skill in the areas requiring development.

Feedback that focuses on the strengths and weaknesses of the trainee’s performance will, through self-reflection, inform their learning and skill development.

For more detail on WBA requirements, please refer to the Workplace-Based Assessment Policy and Procedure.