mini-CEX

 

WHAT IS A MINI-CEX?


This is a 15 minute snapshot of a single doctor/patient interaction in secondary care. It is designed to assess the clinical skills, attitudes and behaviours essential to providing high quality care. It will only ever be done in hospital posts (in GP posts, you do COTs instead).

If you are in a hospital post, you need to do a MINIMUM of:

  • 3 per 6 months in an ST1 post
  • 3 per 6 months in an ST2 post
  • None in  ST3 because this year should be GP based (where you will do COTs instead)

The process is outlined in the diagram on the right.

WHAT CLINICAL AREAS WILL MINI-CEXs COVER? (click to open me)

The following are categories on the assessment form. This should give you some idea.

  1. Pain
  2. Airway/Breathing
  3. CVS/Circulation
  4. Psych/Behaviour
  5. Neuro
  6. Gastro
  7. Other

The assessor decides what aspect ( or problem) of the clinical encounter (s)he is going to focus on. This might be:

  • History
  • Diagnosis
  • Management
  • Explanation

TELL ME MORE ABOUT THE GRADING

The types of things you will be graded on will depend on the focus of the clinical encounter. You may be graded on:

  1. History Taking
  2. Physical Examination Skills
  3. Communication Skills
  4. Clinical judgement
  5. Professionalism
  6. Organisation/Efficiency
  7. Overall clinical care
  8. Anything else that is especially good will also be noted

For each competency assessed, you’ll be given one of the following grades:

  • Insufficient evidence
  • Below expectations
  • Borderline for completion
  • Meets expectations for completion
  • Above expectation

A mark of “insufficient evidence” is always awarded to those competencies that were not tested on this occaison. However, future cases may need to be selected to help you demonstrate these.

ARE NON-CONSULTANTS ALLOWED TO ASSESS ME?

The mini-CEX may be observed by

  • Staff grades
  • Experienced specialty registrars or
  • Consultants

In all cases:

  • there must be a different observer on each occasion
  • immediate feedback needs to be provided to the trainee by the observer
  • and that this feedback should form the basis of a mutually agreed action plan

The evidence will be rated and recorded in the e-portfolio – encourage your observer to do it there and then (otherwise it will never materialise no matter how well intentioned they are – we’re talking from experience).