Application of mini-CEX in community rotation of general practice residency training / 中华全科医师杂志

ABSTRACT

Objective To evaluate the effectiveness of mini clinical evaluation exercise (miniCEX) in community rotation of general practice residency training.Methods Forty nine general practice residency trainees,who participated in community rotation during July 2012 to July 2014 in 3 community teaching bases,were randomly divided into two groups25 trainees in intervention group received conventional teaching and additional 2 rounds of mini-CEX in one month,and 24 trainees received conventional teaching only.The changes of self-evaluation scores of clinical competence after the community rotation were evaluated.Focus group discussions of 8 trainees and 8 teachers from intervention group were also adopted in January to February 2013 to assess the effectiveness of mini-CEX.Results Three trainees withdrew in the study and the interventional group completed 232 mini-CEXs.The self-evaluation scores of clinical competence were elevated in all items in interventional group after community rotation (from 7.03 ± 0.68 to 7.30 ±0.77 in medical history,from 7.00 ± 0.83 to 7.18 ± 0.88 in physical examination,from 7.42 ± 1.20 to 7.52 ± 0.76 in humanistic qualities,from 6.79 ± 0.82 to 7.12 ± 0.70 in clinical judgment,from 6.85 ± 1.06 to 7.18 ± 0.81 in counseling skills,from 6.85 ± 1.15 to 7.12 ± 0.96 in organization,from 7.09 ±0.81 to 7.33 ±0.69 in overall competence),while in control group,scores of humanistic qualities (from 7.74 ± 0.89 to 7.60 ± 0.97),clinical judgment (from 6.94 ± 0.77 to 6.77 ± 1.10) and organization/efficiency (from 6.94 ± 0.96 to 6.80 ± 0.76) were declined.Mter adjusting self-evaluation score before rotation,the increased scores in clinical judgment(7.12 ±0.70 vs.6.77 ± 1.10,F =4.339,P =0.042) and organization (7.12 ± 0.96 vs.6.80 ± 0.76,F =4.336,P =0.042) of intervention group were significantly higher than those of control group.In focus group discussions both trainees and teachers recognized that mini-CEX would enhance clinical competence,be more comprehensive in assessing and adaptable in training program than former rotation tests.The major concerns of using mini-CEX were subjective rating process,non-unified rating standards and insufficient teaching ability.Conclusions Application of mini-CEX in community rotation of general practice residency training can enhance clinical competency of trainees.