Reliability and acceptance of the mini-clinical evaluation exercise as a performance assessment of practicing physicians.

Background: The purpose of this study was to evaluate the reliability and acceptance of the mini-Clinical Evaluation Exercise (mini-CEX) as an assessment of practicing primary care physicians.

Method: Six raters were recruited to conduct the assessments. After a training session, their ability to discriminate between levels of performance was evaluated using videotaped clinical scenarios.

The mini clinical evaluation exercise (mini-CEX) for assessing clinical performance of international medical graduates.

Objective: To evaluate the feasibility, reliability and acceptability of the mini clinical evaluation exercise (mini-CEX) for performance assessment among international medical graduates (IMGs).

Design, Setting And Participants: Observational study of 209 patient encounters involving 28 IMGs and 35 examiners at three metropolitan teaching hospitals in New South Wales, Victoria and Queensland, September-December 2006.

Main Outcome Measures: The reliability of the mini-CEX was estimated using generalisability (G) analysis, and its acceptability was evaluated by a written survey of the examiners and IMGs.

Student learning experiences in a longitudinal clerkship programme.

Objective: To identify how medical student learning experiences in a new longitudinally integrated clinical clerkship (LICC) programme impacted students' learning.

Methods: We conducted semi-structured interviews with 12 medical students at three points in their training. We used an inductive, thematic analytic approach to data.

The High Clinic: a pilot project of a new model for an outpatient, community-based teaching clinic in rheumatology.

The objectives were to develop an outpatient, community-based clinical education experience for second-year rheumatology fellows based on sound education principles, and to pilot the program to test its practicability and assess student perception of its educational efficacy. The outpatient clinical education experience consisted of four steps. In Step 1 second-year rheumatology fellows assessed patients and reviewed their cases with two supervisors.

How specific is case specificity?

Objectives: Case specificity implies that success on any case is specific to that case. In examining the sources of error variance in performance on case-based examinations, how much error variance results from differences between cases compared with differences between items within cases? What is the optimal number of cases and questions within cases to maximise test reliability given some fixed period of examination time?

Methods: G and D generalisability studies were conducted to identify variance components and reliability for each examination analysed, and to optimise the reliability of the given test composition (1, 1.5, 2, 3, 4 and 5 questions per case), using data from 3 key features examinations of the Medical Council of Canada (n = 6342 graduating medical students), each of which consisted of about 35 written cases followed by 1- questions regarding specific key elements of data gathering, diagnosis and/or management.

A practical guide to assessing clinical decision-making skills using the key features approach.

Aim: This paper in the series on professional assessment provides a practical guide to writing key features problems (KFPs). Key features problems test clinical decision-making skills in written or computer-based formats. They are based on the concept of critical steps or 'key features' in decision making and represent an advance on the older, less reliable patient management problem (PMP) formats.

Procedures for establishing defensible programmes for assessing practice performance.

The assessment of the performance of doctors in practice is becoming more widely accepted. While there are many potential purposes for such assessments, sometimes the consequences of the assessments will be 'high stakes'. In these circumstances, any of the many elements of the assessment programme may potentially be challenged.