Impact of Mini-CEX and DOPS on clinical competence and satisfaction among final year medical students: a comparative interventional study

Main Article Content

Zeelaf Shahid
Kiran Fatima
Yamna Khan
Madiha Fatima Agha
Urooj Fatima

Abstract

OBJECTIVE: To compare pre- and post-mean scores of Mini-Clinical Evaluation Exercise (Mini-CEX) and Direct Observation of Procedural Skills (DOPS), and to assess supervisor and student satisfaction with Mini-CEX and DOPS over time among final year medical undergraduates.


METHODS: This study was conducted on 90 final year medical students at a Private Medical College in Karachi from May 2022 to November 2022. Pre- and post-testing involved Objective Structured Clinical Examination before and after the last session of DOPS and Mini-CEX, comprising six stations. Workshops on Mini-CEX and DOPS were conducted for supervisors and students before pre-testing. Core clinical competencies included history taking, physical examination, counselling skills, critical thinking, professionalism, organization, management skills, and overall clinical performance. Data was analysed through SPSS version-23.


RESULTS: Over six months, 1080 encounters were conducted among 90 students in six sessions. Mean pre-test score for Mini-CEX was 13.78±3.61 and for DOPS was 11.57±3.0, with post-test scores of 43.61±3.38 and 42.28±1.8, respectively (p-value <0.0001). Management skills were most frequently assessed in Mini-CEX, while DOPS mainly evaluated counseling skills. Progressive improvement was noted across each session of Mini-CEX and DOPS, with mean scores increasing from 1.8 to 4.73 for Mini-CEX and from 1.8 to 2.88 for DOPS. Supervisor satisfaction rose from 2.53 to 4.64 for DOPS and from 1.04 to 2.53 for Mini-CEX over the six encounters. Majority of students expressed satisfaction with both assessments.


CONCLUSION: Our study demonstrated significant improvement in clinical competencies over time assessed by Mini-CEX and DOPS, with high satisfaction among students and supervisors.

Article Details

How to Cite
Shahid, Z., K. Fatima, Y. Khan, M. F. Agha, and U. Fatima. “Impact of Mini-CEX and DOPS on Clinical Competence and Satisfaction Among Final Year Medical Students: A Comparative Interventional Study”. KHYBER MEDICAL UNIVERSITY JOURNAL, vol. 16, no. 2, June 2024, doi:10.35845/kmuj.2024.23418.
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Original Articles

References

Lörwald AC, Lahner FM, Greif R, Berendonk C, Norcini J, Huwendiek S. Factors influencing the educational impact of Mini-CEX and DOPS: a qualitative synthesis. Med Teach 2018 Apr 3;40(4):414-20. https://doi.org/10.1080/0142159X.2017.1408901

Martinsen SS, Espeland T, Berg EA, Samstad E, Lillebo B, Slørdahl TS. Examining the educational impact of the mini-CEX: a randomised controlled study. BMC Med Educ 2021;21:1-0. https://doi.org/10.1186/s12909-021-02670-3

Norcini JJ, Blank LL, Arnold GK, Kimball HR. The mini-CEX (clinical evaluation exercise): a preliminary investigation. Ann Intern Med 1995;123(10):795-9. https://doi.org/10.7326/0003-4819-123-10-199511150-00008

Khanghahi ME, Azar FE. Direct observation of procedural skills (DOPS) evaluation method: Systematic review of evidence. Med J Islamic Republic Iran 2018;32:45. https://doi.org/10.14196/mjiri.32.45

Shah MI, Qayum I, Bilal N, Ahmed S. Evaluation of an implemented Mini-CEX program for workplace-based assessment at Rehman Medical College, Peshawar, Khyber Pakhtunkhwa. Professional Med J 2021;28(9):1346-50. https://doi.org/10.29309/TPMJ/2021.28.09.6120

Azeem MU, Bukhari FA, Manzoor MU, Raza A, Haq A, Hamid W. Effectiveness of mini-clinical evaluation exercise (Mini-CEX) With multisource feedback as assessment tool for orthodontic PG residents. Pak J Health Med Sci 2020;14(3):647-9.

Dabir S, Hoseinzadeh M, Mosaffa F, Hosseini B, Dahi M, Vosoughian M et al. The effect of repeated direct observation of procedural skills (R-DOPS) assessment method on the clinical skills of anaesthesiology residents. Anaesthesiol Pain Med 2021;11(1). https://doi.org/10.5812/aapm.111074

Kara CO, Mengi E, Tümkaya F, Topuz B, Ardıç FN. Direct observation of procedural skills in otorhinolaryngology training. Turkish Arch Otorhinolaryngol 2018;56(1):7. https://doi.org/10.5152/tao.2018.3065

Alam I, Ali Z, Muhammad R, Afridi MA, Ahmed F. Mini-CEX: an assessment tool for observed evaluation of medical postgraduate residents during their training program: an overview and recommendations for its implementation in CPSP residency program. J Postgrad Med Inst 2016;30(2):110-4.

Ehsan S, Usmani A. Effectiveness of Mini-CEX as an assessment tool in Pediatric Postgraduate Residents’ Learning. J Liaq Uni Med Health Sci 2023;22(01):50-4. https://doi.org/10.22442/jlumhs.2022.00982

Kim S, Willett LR, Noveck H, Patel MS, Walker JA, Terregino CA. Implementation of a mini-CEX requirement across all third-year clerkships. Teach Learn Med 2016;28:424-31. https://doi.org/10.1080/10401334.2016.1165682

Jafarpoor H, Hosseini M, Sohrabi M, Mehmannavazan M. The effect of direct observation of procedural skills/mini-clinical evaluation exercise on the satisfaction and clinical skills of nursing students in dialysis. J Educ Health Prom 2021;10. https://doi.org/10.4103/jehp.jehp_618_20

Buch PM. Impact of introduction of Mini-Clinical Evaluation Exercise in formative assessment of undergraduate medical students in pediatrics. Int J Contemp Pediatr 2019;6(6):2248-53. http://dx.doi.org/10.18203/2349-3291.ijcp20194700

Sethi S, Srivastava V, Verma P. Mini-Clinical Evaluation Exercise as a Tool for Formative Assessment of Postgraduates in Psychiatry. Int J Appl Basic Med Res 2021;11(1):27-31. https://doi.org/10.4103/ijabmr.IJABMR_305_20

Azeem M, Usmani A, Ashar A. Effectiveness of Direct Observation of Procedural Skills (DOPS) for Improving the Mini-Implant Insertion Procedural Skills of Postgraduate Orthodontic Trainees. Pak J Med Health Sci 2022;16(05):192-4. https://doi.org/10.53350/pjmhs22165192

Kamat C, Todakar M, Patil M, Teli A. Changing trends in assessment: Effectiveness of Direct observation of procedural skills (DOPS) as an assessment tool in anesthesiology postgraduate students. J Anaesthesiol Clin Pharmacol 2022;38(2):275. https://doi.org/10.4103/joacp.JOACP_329_20

Inamdar P, Hota PK, Undi M. Feasibility and Effectiveness of Direct Observation of Procedure Skills (DOPS) in General Surgery discipline: a Pilot Study. Indian J Surg 2022;84(Suppl 1):109-14.

Qureshi MA, Latif MZ. Experience of Dops (Direct Observation Practical Skills) By Postgraduate General Surgical Residents of Lahore. Esculapio 2023;19(01):91-5. https://doi.org/10.51273/esc23.2519119

Mehranfard S, Pelarak F, Mashalchi H, Kalani L, Masoudiyekta L. Efficacy of logbook as a clinical assessment: Using DOPS evaluation method. J Multidiscip Care 2022;11(4):185. https://doi.org/10.34172/jmdc.2022.62

Handayani NP, Menaldi SL, Felaza E. Exploration of the implementation of direct observation of procedural skill as an instrument for evaluation of clinical skills in dental professional education. Makassar Dent J 2022;11(1):42-7. https://doi.org/10.35856/mdj.v11i1.507