The influence of students’ prior clinical skills and context characteristics on mini-CEX scores in clerkships – a multilevel analysis

BMC Medical Education

Research Article

Christoph Berendonk¹  Christine Beyeler¹  Patrick Jucker-Kupper¹  Stephanie Montagne¹  Sören Huwendiek¹  Anja Rogausch²  Wolfgang Himmel³  Armin Gemperli⁴ 

[1] Department of Assessment and Evaluation, Institute of Medical Education, University of Bern, Bern, Switzerland;Department of Assessment and Evaluation, Institute of Medical Education, University of Bern, Bern, Switzerland;Clinic Sonnenhalde, Riehen, Switzerland;Department of General Practice, University Medical Center, Göttingen, Germany;Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland;Swiss Paraplegic Research Nottwil, Nottwil, Switzerland;

关键词: Clinical Competence;    Educational measurement;    Education;    Medical;    Undergraduate;    Task Performance and analysis;    Workplace;    Clinical clerkship;    Psychometrics;   

DOI  :  10.1186/s12909-015-0490-3

 received in 2015-03-31, accepted in 2015-11-19,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundIn contrast to objective structured clinical examinations (OSCEs), mini-clinical evaluation exercises (mini-CEXs) take place at the clinical workplace. As both mini-CEXs and OSCEs assess clinical skills, but within different contexts, this study aims at analyzing to which degree students’ mini-CEX scores can be predicted by their recent OSCE scores and/or context characteristics.MethodsMedical students participated in an end of Year 3 OSCE and in 11 mini-CEXs during 5 different clerkships of Year 4. The students’ mean scores of 9 clinical skills OSCE stations and mean ‘overall’ and ‘domain’ mini-CEX scores, averaged over all mini-CEXs of each student were computed. Linear regression analyses including random effects were used to predict mini-CEX scores by OSCE performance and characteristics of clinics, trainers, students and assessments.ResultsA total of 512 trainers in 45 clinics provided 1783 mini-CEX ratings for 165 students; OSCE results were available for 144 students (87 %). Most influential for the prediction of ‘overall’ mini-CEX scores was the trainers’ clinical position with a regression coefficient of 0.55 (95 %-CI: 0.26–0.84; p < .001) for residents compared to heads of department. Highly complex tasks and assessments taking place in large clinics significantly enhanced ‘overall’ mini-CEX scores, too. In contrast, high OSCE performance did not significantly increase ‘overall’ mini-CEX scores.ConclusionIn our study, Mini-CEX scores depended rather on context characteristics than on students’ clinical skills as demonstrated in an OSCE. Ways are discussed which focus on either to enhance the scores’ validity or to use narrative comments only.

【 授权许可】

CC BY   
© Rogausch et al. 2015