Mini clinical evaluation exercise: validity and feasibility evidences in literature

Clinical skills assessment has a very important role in Health Professions Education. However, the basic requirements of its reliability and validity have not been achieved or taken much care of. A mini Clinical Evaluation Exercise (mini-CEX) is approximately a twenty minute encounter, during which a trainee performs focused history taking and physical examination of a patient in a real setting while the faculty assessor observes. After a discussion on the diagnosis and management plan for the patient, the faculty assesses the trainee using the mini-CEX evaluation form and provides feedback. Based on the literature review mini-CEX is found to be a valid and reliable assessment strategy for clinical competence. It has shown to be content valid and differentiates well between different performance levels for both postgraduate and undergraduate trainees. The results are fairly reliable on four or more encounters with the standard error of measurement being very small. The mini-CEX scores have shown to be criterion valid and have sufficient desired educational impact on trainees. Overall, mini-CEX is found to be a fairly valid and feasible assessment strategy for clinical skills justifying its use for both under-graduate and post-graduate education.