A qualitative study of foundation doctors' experiences with mini-CEX in the UK

Olukayode M. Tokode and Reg Dennick

Medical Education Unit, School of Medicine, University of Nottingham, UK

Submitted: 23/04/2012; Accepted: 10/04/2013; Published: 04/05/2013

Int J Med Educ. 2013; 4:83-92; doi: 10.5116/ijme.5165.e5d8

© 2013 Olukayode M. Tokode & Reg Dennick. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use of work provided the original work is properly cited. http://creativecommons.org/licenses/by/3.0

Objectives: To explore foundation trainees' experiences with the mini clinical evaluation exercise (mini-CEX).

Methods: Data were gathered from interviews with thirty foundation year one trainees who had completed a minimum of six assessments with the mini-CEX tool. Interview transcripts were analysed using a template thematic procedure.

Results: Trainees reported divergent views regarding the goals and the standard of the assessment. Surface and strategic approaches were the commonly reported approaches to the mini clinical assessment. Assessment standards were frequently subverted in favour of retrospective, ad hoc and absentia approaches. Non-specific feedback was common and explicit action plans were infrequent. All trainees applauded the formative potential of the mini-CEX but there were mixed perceptions of its educational value. Some considered it useful and spoke of their positive experiences in terms of theoretical knowledge, clinical competencies and daily clinical practice. Others considered their experiences unremarkable; and some other respondents felt mini-CEX was valueless, and described it as an administrative burden. Respondents felt that, trainee's personality, maturity and learning style, ambiguity in the use of assessment result, assessor's skills and attitude, and the clinical environment, were important to their experiences with mini-CEX.

Conclusions: The trainees recognised the potential of the mini-CEX. Adequate knowledge about the assessment standard and guidelines were generally lacking. There was perceived tension between mini-CEX formative and summative purposes. This and other contextual factors probably shaped the trainees' experiences with mini-CEX.