title: Feasibility, reliability and user satisfaction with a PDA-based mini-CEX to evaluate the clinical skills of third-year medical students.
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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
authors.affiliation: General Internal Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin 53226, USA. dtorre@mcw.edu
authors.forename: Dario M
authors.initials: DM
authors.lastname: Torre
authors.forename: Deborah E
authors.initials: DE
authors.lastname: Simpson
authors.forename: D Michael
authors.initials: DM
authors.lastname: Elnicki
authors.forename: James L
authors.initials: JL
authors.lastname: Sebastian
authors.forename: Eric S
authors.initials: ES
authors.lastname: Holmboe
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D034201:Computers, Handheld; D003258:Consumer Behavior; D005240:Feasibility Studies; D005246:Feedback; D006801:Humans; D011361:Professional Competence; D015203:Reproducibility of Results; D013337:Students, Medical; D014922:Wisconsin