The mini clinical evaluation exercise (mini-CEX) for assessing clinical performance of international medical graduates.

OBJECTIVE: To evaluate the feasibility, reliability and acceptability of the mini clinical evaluation exercise (mini-CEX) for performance assessment among international medical graduates (IMGs). DESIGN, SETTING AND PARTICIPANTS: Observational study of 209 patient encounters involving 28 IMGs and 35 examiners at three metropolitan teaching hospitals in New South Wales, Victoria and Queensland, September-December 2006. MAIN OUTCOME MEASURES: The reliability of the mini-CEX was estimated using generalisability (G) analysis, and its acceptability was evaluated by a written survey of the examiners and IMGs. RESULTS: The G coefficient for eight encounters was 0.88, suggesting that the reliability of the mini-CEX was 0.90 for 10 encounters. Almost half of the IMGs (7/16) and most examiners (14/18) were satisfied with the mini-CEX as a learning tool. Most of the IMGs and examiners enjoyed the immediate feedback, which is a strong component of the tool. CONCLUSION: The mini-CEX is a reliable tool for performance assessment of IMGs, and is acceptable to and well received by both learners and supervisors.

Procedures for establishing defensible programmes for assessing practice performance.

The assessment of the performance of doctors in practice is becoming more widely accepted. While there are many potential purposes for such assessments, sometimes the consequences of the assessments will be 'high stakes'. In these circumstances, any of the many elements of the assessment programme may potentially be challenged. These assessment programmes therefore need to be robust, fair and defensible, taken from the perspectives of consumer, assessee and assessor. In order to inform the design of defensible programmes for assessing practice performance, a group of education researchers at the 10th Cambridge Conference adopted a project management approach to designing practice performance assessment programmes. This paper describes issues to consider in the articulation of the purposes and outcomes of the assessment, planning the programme, the administrative processes involved, including communication and preparation of assessees. Examples of key questions to be answered are provided, but further work is needed to test validity.