title: Clinical skills evaluation of trainees in a neurology department.
abstract: Three to 12 evaluations of clinical performance using the mini-clinical evaluation exercise (Mini-CEX) (n = 124) or direct observation of procedural skills (DOPS) (n = 21) were performed on 27 trainees working in an NHS neurology department. The communications/ counselling skills subdomain was scored in 64 evaluations. For Mini-CEX the focus was on gathering data (22%), diagnosis (31%), management (34%) and counselling (7%) (focus not recorded in 6%). For DOPS, lumbar puncture was the most common evaluated procedure (57%). Mini-CEX evaluations lasted 23.8 minutes (10.6) (mean, sd) and DOPS 25.9 minutes (12.6). Mini-CEX scores for overall competence and communication skills were mean 5.99 (sd 0.95, range 4-8) and 5.98 (sd 1.21, range 3-9) and for DOPS 5.71 (sd 0.90, range 4-8) both on scales of 1 to 9. Overall trainee competence and communication scores increased with year of training (p < 0.001, p < 0.004 univariate analysis). Assessors undertook up to three or four assessments in a session. Assessors and trainees considered that the observation and feedback had been 'very' or 'quite' useful in providing a relevant element of assessment. These assessments were feasible and useful in a neurology department and provided some evidence for increasing performance with trainee seniority. More assessor time (approximately one hour) than trainee time (24-26 min) was needed for each assessment undertaken.
authors: Department of Neurology, Cardiff University. wiles@cf.ac.uk
authors: C M
authors: CM
authors: Wiles
authors: K
authors: K
authors: Dawson
authors: T A T
authors: TA
authors: Hughes
authors: J G
authors: JG
authors: Llewelyn
authors: H R
authors: HR
authors: Morris
authors: T P
authors: TP
authors: Pickersgill
authors: N P
authors: NP
authors: Robertson
authors: P E M
authors: PE
authors: Smith
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D004650:Employee Performance Appraisal / Q000379:methods*; D006801:Humans; D009462:Neurology; D013222:State Medicine; D006113:United Kingdom