A New Performance Assessment Method in Clinical Education: Mini-Clinical Evaluation Exercise

Öz

Medical education is a specialized education model as the professional qualifications, direct contact with the patient, skills and attitudes based on the competencies are being tested. It is important to use various measurement and assessment methods for gathering information about what the students will do to transfer acquired knowledge, skill and attitude in their real life when they are experienced. Mini-Clinical Evaluation Exercise is an assessment method used for this purpose. The evaluator and the student interact with the patient on the real work during mini-clinical evaluation exercise. The application takes about 15-20 minutes. The students encounter with different patients in different environments with different diagnosis therefore; they find the opportunity to exhibit their performance. They can improve the lacking aspects and can ameliorate the best aspects as they get the feedback from the evaluator about their performance. This article gives information about mini-clinical evaluation exercise such as what it is related about, how it is implemented, how the assessment is made and what are the advantages and disadvantages of the method. Implementation of the mini clinical evaluation exercise in medical faculties and sharing of the results in academic fields are important step for dissemination of performance assessment in medical education.

Anahtar Kelimeler

• performance assessment, mini clinical evaluation exercise, clinical education

Klinikte Eğitimde Yeni Bir Ölçme Yöntemi: Mini Klinik Değerlendirme

Öz

Tıp eğitimi mesleksel yeterliklerin, hastayla direk temasın, beceri ve tutuma dayalı yeterliklerin sınanması nedeniyle özellikli bir eğitimdir. Öğrencilerin edindikleri bilgi, beceri ve tutumu gerçek yaşama aktarabileceklerine dair bilgi edinebilmek için çeşitli ölçme-değerlendirme yöntemlerinin kullanılması önemlidir. Mini Klinik Değerlendirme bu amaçla kullanılan bir ölçme - değerlendirme yöntemidir. Mini Klinik Değerlendirmede değerlendirici ve öğrenci hasta ile gerçek iş üzerinde etkileşmektedir. Uygulama 15-20 dakika sürmektedir. Böylece öğrenci farklı ortamlarda, farklı hastalarla, farklı hastalıklarla karşılaşma olanağı bularak performansını sergilemektedir. Bu performansı hakkında değerlendiriciden geribildirim alarak eksik yönlerini tamamlama, iyi yönlerini ise geliştirme olanağı bulmaktadır. Bu yazıda mini klinik değerlendirme yöntemi ile ilgili; ne olduğu, nasıl uygulandığı, değerlendirmesinin nasıl yapıldığı, avantaj ve dezavantajlarının neler olduğuna dair bilgiler aktarılmıştır. Tıp fakültelerinde mini klinik değerlendirmenin uygulanması ve uygulama sonuçlarının akademik ortamlarda paylaşılması, performans değerlendirmenin tıp eğitiminde yaygınlaşması için atılacak önemli adımlar arasındadır.

Anahtar Kelimeler

• performans değerlendirme, mini klinik değerlendirme, klinikte eğitim

Kaynakça

1. General Medical Council (GMC) Tomorrow’s doctors. London: GMC Publishing, 2003.
2. Terzi C, Saçaklıoğlu F, Sayek İ. 2020 Yılında Türkiye’de
3. Tıp Eğitimi. Ankara: Türk Tabipleri Birliği Yayınları, 2002.
4. Linn RL, Miller MD. Measurement and assessment in teaching. New Jersey: Pearson/Merrill Prentice-Hall, 2005.
5. Miller GE. The assessment of clinical skills / competence / performance. Academic Medicine 1990;65:S63-7.
6. Hauer EK, Mazotti L, O’Brien B, Hemmer AP, Tong L. Faculty verbal evaluations reveal strategies used to promote medical student performance. Medical Education 2011;16(6354):1-9.
7. Rolfe IE, Sanson-Fisher RW. Translating learning principles into Practice. Medical Education 2002;36:345-352.
8. Harden RM, AMEE Guide No.21:Curriculum mapping: A tool for transparent and authentic teaching and learning. Medical Teacher 2001;23(2):123-137.

9. Harden, R.M., Crosby, J.R., Davis, M.H. AMEE Guide No. 14: Outcome-based education: Part1 -An introduction to outcome-based education. Medical Teacher 1999;21(1):7-14.
10. Davis MH, Karunathilake I. The place of oral Examination in today’s assessment systems. Medical Teacher 2005;27(4):292-297.
11. Kogan JR, Holmboe ES, Hauer KE. Tools for direct observation and assessment of clinical skills of medical trainees: A systematic review. JAMA 2009; 302(12):1316– 13
12. Van Der Vleuten CPM, Schuwirth LWT. Assessing professional competence: from methods to programmes. Medical Education 2005;39:309–317.
13. Van Der Vleuten CPM. The assessment of professional competence: developments, research and practical implications. Advances in Health Sciences Education 1996;1:41–67.
14. Hays R. Assessment in medical education: roles for clinical teachers. The Clinical Teacher 2008;5:23-27.
15. Norcini JJ, Blank LL, Arnold GK, Kimball HR. The Mini-CEX (Clinical Evaluation Exercise): A Preliminary Investigation. Annals of Internal Medicine 1995;123(10):795- 7
16. Norcini JJ, Blank LL, Duffy FD, Fortna GS. The Mini- CEX: A Method for Assessing Clinical Skills. Annals of Internal Medicine. 2003;138:476-481.
17. The Mini-CEX A Quality Tool In Evaluation. (2001- 2002). American Board of InternalMedicine. www. personalbesthealth.com/literature%20Web/Articles/
18. Mini-CEX%20Guidelines.pdf adresinden 01.06.2013’da ulaşılmıştır.
19. Hill F, Kendall K. Adopting and adapting the mini-CEX as an undergraduate assessment and learning tool. The Clinical Teacher 2007;4:244-248.
20. Hill F, Kendall K, Galbraith K, Crossley J. Implementing the undergraduate mini-CEX: a tailored approach at Southampton University. Medical Education 2009;43:326- 3
21. Alves de Lima A, Barrero C, Baratta S, Castillo Costa Y, Bortman G, Arabajales J, et al. Validity, reliability, feasibility and satisfaction of the Mini-Clinical Evaluation Exercise (Mini-CEX) for cardiology residency training. Medical Teacher 2007;29: 785–790.
22. Golnik KC, Goldenhar LM, Gittinger JW, Lustbader JM. The Ophthalmic Clinical Evaluation Exercise (OCEX). Ophthalmology 2004;111:1271–1274.
23. Lin Chaou-Shune, Te-Fa Chiu, Yen David HT, Chee-Fah Chong. Mini-Clinical Evaluation Exercise and Feedback on Postgraduate Traniess in the Emergency Department: A Qualitative Content Analysis. Journal of Acute Medicine 2012;2:1-7.
24. Weller JM, Jolly B, Misur MP, Merry AF, Jones A, Crossley JGM, Pedersen K, Smith K. Mini-clinical evaluation exercise in anesthesia training. British Journal of Anaesthesia 2009;102:633–641.
25. Sidhu RS, Hatala R, Barron S, Broudo M, Pachev G, Page G. Reliability and acceptance of the mini-clinical evaluation exercise as performance assessment of practicing physicians. Academic Medicine 2009;84:S113–S115.
26. Hatala R, Ainslie M, Kassen BO, Mackie I, Roberts JM. Assessing the mini-clinical evaluation exercise in comparison to a national specialty examination. Medical Education 2006;40:950–956.
27. Kogan JR, Bellini LM, Shea JA. Implementation of the mini-CEX to evaluate medical students’ clinical skills. Academic Medicine 2002;77:1156–1157.
28. Kogan JR, Bellini LM, Shea JA. Feasibility, reliability, and validity of the mini-clinical evaluation exercise (mCEX) in a medicine core clerkship. Academic Medicine 2003;78:33– S
29. Kogan JR, Hauer KE. Brief report: Use of the mini-clinical evaluation exercise in internal medicine core clerkships. Journal of General Internal Medicine 2006;21:501–502.
30. Holmboe ES, Yepes M, Williams F, Huot S. Feedback and The Mini Clinical Evaluation Exercise. J Gen Internal Medicine 2004;19:558-561.
31. Tengiz Fİ. Mini klinik değerlendirme (mini-CEX) yönteminin psikometrik özelliklerinin ve kullanışlılığının değerlendirilmesi “Ege Üniversitesi Tıp Fakültesi örneği”. Yayınlanmamış Doktora tezi. Ege Üniversitesi Sağlık Bilimleri Enstitüsü. İzmir 2013.