Assessing the mini-Clinical Evaluation Exercise in comparison to a national specialty examination.
OBJECTIVE
To evaluate the reliability and validity of the Mini-Clinical Evaluation Exercise (mini-CEX) for postgraduate year 4 (PGY-4) internal medicine trainees compared to a high-stakes assessment of clinical competence, the Royal College of Physicians and Surgeons of Canada Comprehensive Examination in Internal Medicine (RCPSC IM examination).


METHODS
Twenty-two PGY-4 residents at the University of British Columbia and the University of Calgary were evaluated, during the 6 months preceding their 2004 RCPSC IM examination, with a mean of 5.5 mini-CEX encounters (range 3-6). Experienced Royal College examiners from each site travelled to the alternate university to assess the encounters.


RESULTS
The mini-CEX encounters assessed a broad range of internal medicine patient problems. The inter-encounter reliability for the residents' mean mini-CEX overall clinical competence score was 0.74. The attenuated correlation between residents' mini-CEX overall clinical competence score and their 2004 RCPSC IM oral examination score was 0.59 (P = 0.01).


CONCLUSIONS
By examining multiple sources of validity evidence, this study suggests that the mini-CEX provides a reliable and valid assessment of clinical competence for PGY-4 trainees in internal medicine.
Hatala
Rose
R
University of British Columbia, Canada. rhatala@mac.com
Ainslie
Martha
M
Kassen
Barry O
BO
Mackie
Iain
I
Roberts
J Mark
JM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001955:British Columbia; D002982:Clinical Clerkship / Q000592:standards*; D002983:Clinical Competence / Q000592:standards*; D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D008297:Male; D008875:Middle Aged