Effect of Mini-CEX as formative learning tool for clinical skills in undergraduate medical students in a private medical university in Karachi, Pakistan

迷你临床技能测试(Mini-CEX)作为巴基斯坦卡拉奇一所私立医科大学本科医学生临床技能形成性学习工具的效果

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Abstract

INTRODUCTION: The mini clinical evaluation exercise (Mini-CEX) is one of the well-known tools of workplace-based assessment (WPBAs) used in medical Education. The effectiveness of this method needs to be determined for undergraduate learning, just as it is already in use for post graduate training. OBJECTIVE: To study the effect of Mini-CEX as formative learning tool for clinical skills in undergraduate medical students in a private medical university in Karachi, Pakistan. MATERIAL AND METHODS: Setting is Bahria Medical and Dental College with a total duration of one year. This study is a quasi-experimental design with simple random sampling. A total of 143 final-year MBBS students were recruited after obtaining informed written consent. Participants were randomly allocated into four groups, with each group completing a two-month clinical rotation in the Pediatrics Department during the academic year. Randomization was performed using an online random selection generator (Berman H.G., "Random Number Generator"). Students assigned to the Pediatrics rotation were randomized into two control groups and two intervention (case) groups. Weekly, students were further randomized and assigned to different faculty members to minimize instructor-related bias. The random number was generated by producing 146 unique random numbers within the range of 1 to 146, ensuring that no duplicates were included. The Pediatric faculty was trained on how to use Mini-CEX form during daily teaching sessions. One briefing session was followed by personalized hands-on training on how to use the form and also to provide step by step feedback to students. Another questionnaire form sent to the students to ask about their opinion and concerns regarding the effectiveness of this process. The ward test marks evaluated. Analysis done on SPSS version 22. Data collection after approval from IRB. RESULT: Out of 143 students, 76 (53.1%) received Mini-CEX evaluations. Intervention groups achieved higher ward test (72.3 ± 7.5 vs. 65.4 ± 8.2; p = 0.002; d = 0.65) and OSCE scores (75.6 ± 6.9 vs. 68.1 ± 7.8; p = 0.001; d = 0.71) than controls. Among 61 respondents (80.3%), 85.2% reported improved clinical skills and confidence, with limited faculty availability noted as a barrier. CONCLUSION: Mini-CEX improved clinical competence, confidence, and assessment scores, confirming effectiveness as a formative tool, though faculty training and time limitations remain notable implementation barriers.

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