scholarly journals Introduction of Mini-clinical Evaluation Exercise for the Formative Assessment of Postgraduates in the General Surgery Discipline

2020 ◽  
Author(s):  
Kailash Charokar ◽  
Anil Kapoor
Keyword(s):  
Formative Assessment ◽  
Clinical Evaluation ◽  
General Surgery ◽  
Assessment Tool ◽  
Clinical Skills ◽  
Statistical Significance ◽  
P Value ◽  
Global Rating ◽  
Feedback Questionnaire ◽  
One Year

Introduction: The common practice prevalent in most of the Postgraduate (PG) teaching institutes is that while the PGs are clinically evaluating the patients for the traditional long case, they are mostly not directly observed by the faculty. The presentation of the case by PGs is the main focus of assessment. Workplace Based Assessment (WPBA) tools assess the clinical competence of students at the ‘does’ level of Miller’s pyramid, while they perform in a real setting. Aim: To assess the feasibility, acceptability and effectiveness of Mini-Clinical Evaluation Exercises (Mini-CEX) for the PGs in Surgery. Materials and Methods: This educational intervention study was conducted in the General Surgery Department, over a period of one year. Sixteen PGs of 1st, 2nd, and 3rd-year residency participated in the study, and 13 faculty as assessors. The Mini-CEX was conducted and the abim.org proforma was used to record the observations by the faculty. The perceptions of the PGs and faculty were obtained at the end of the study using a predesigned validated feedback questionnaire. The change in the level of acquisition of clinical skills of the PGs was evaluated using the group mean, median and rank. The Friedman test was applied to calculate the statistical significance at p<0.05 using Statistical Package for the Social Sciences (SPSS) version 20. Results: A total of 124 Mini-CEX encounters were conducted over a period of one year. The mean satisfaction score for the Mini-CEX encounters was 7.3±0.88 and 6±0.89 on the global rating (0-9) among the PGs and faculty respectively. While 14 PGs (87.5%) accepted that Mini-CEX was easy to conduct as compared to the traditional long case. Ten faculty (76.5%) accepted that it was feasible to conduct with the prevailing professional workload. Twelve PGs perceived that Mini-CEX was an effective tool for improving clinical skills. Statistically significant (p-value <0.05) improvement was found in the competencies of medical interviewing, physical examination, counseling skills, and professionalism. Conclusion: Mini-CEX was acceptable to the PGs and faculty. It was found to be an effective and formative assessment tool for learning clinical skills in a supportive workplace-based environment for clinical skills improvements

scholarly journals Impact of introduction of Mini-Clinical Evaluation Exercise in formative assessment of undergraduate medical students in pediatrics

2019 ◽  
Vol 6 (6) ◽  
pp. 2248
Author(s):  
Pankaj M. Buch
Keyword(s):  
Formative Assessment ◽  
Clinical Evaluation ◽  
Assessment Tool ◽  
Clinical Skills ◽  
Data Gathering ◽  
Undergraduate Medical Students ◽  
Undergraduate Level ◽  
Evaluation Exercise ◽  
Systemic Process ◽  
Teaching Learning

Background: Student’s assessment is a systemic process of determining the extent to which the student has achieved the desired competency. Mini–Clinical Evaluation Exercise (Mini-CEX) is an assessment tool applicable in broad range of settings. Very little data is available in Indian settings about Mini-CEX in undergraduate. This study has been undertaken to understand its role in formative assessment.Methods: In this interventional study 47 students and 7 faculty of pediatrics participated. Students were assessed for two encounters of Mini-CEX. Assessment was as per Mini-CEX rating form followed by feedback.Results: Mean score range for different competency of data gathering were 1.76 to 2.5 during first mini-CEX and 4.38 to 5.14 during second Mini-CEX. Difference was significant (Cohen’s d >0.8). More than 90% of students felt that Mini-CEX is better way to assess clinical skills and would like to be assessed by Mini-CEX. One to one interaction was most important advantage felt about Mini-CEX. Though nearly all faculties felt that Mini-CEX is a better way for assessment half of them disagree to continue using it in future due to time constraints.Conclusions: In this study we found Impact of Mini-CEX in formative assessment is significant to improve clinical competency at undergraduate level. Improvement in Mini-CEX scores in consecutive encounter signifies its role even as Teaching Learning tool. Need to consider issues about its feasibility for Undergraduate level in settings with limited staff strength.

Structured Long Interview and Clinical Examination (SLICE) as Formative Assessment Tool in Clinical Clerkship: Medical Students Perspective

2021 ◽  
pp. 1-16
Author(s):  
Wajiha Shadab ◽  
Amna Ahmed Noor ◽  
Saira Waqqar ◽  
Gul Muhammad Shaikh
Keyword(s):  
Medical Students ◽  
Formative Assessment ◽  
Thematic Analysis ◽  
Assessment Tool ◽  
Clinical Skills ◽  
General Medicine ◽  
Sampling Technique ◽  
Clinical Clerkship ◽  
Primary Investigator ◽  
Skills Learning

Abstract Objective: This study aimed to assess the medical students’ opinions and views on undertaking SLICE as a formative assessment. Methods: This was a qualitative, exploratory study. Purposive sampling technique was used to select final year medical students who have undertaken a formative assessment through SLICE in their clerkship rotation. Total 32 students participated in this study .Four sets of focus group discussions (FGD) were conducted from medical students who had recently gone through their clinical clerkship modules for Pediatrics, General Medicine, General Surgery and Gynecology& Obstetrics. Each recorded FGD was transcribed verbatim. Thematic analysis was conducted manually. Themes were identified from the transcribed data, coded and analyzed. In order to achieve adequate coding and researcher reliability, investigator triangulation was performed. The initial thematic analysis was performed by the primary investigator. Thereafter, two more investigators independently analyzed the data. Before the data was finalized, all the three investigators reached a final consensus upon the themes that had emerged, ensuring triangulation of the analyzed data. Results: A four staged thematic analysis was conducted, in which five major themes and five sub-themes emerged. The main themes being: Purpose, Learning, Timing, Relevancy and Fairness of SLICE. Conclusion: The students generally thought that SLICE was effective in enhancing their clinical skills learning and should be conducted more frequently with minor adjustments. Continuous...

scholarly journals Perception of OSCE as An Assessment Tool in Undergraduate Students of Private Medical College in Karachi, Pakistan

2021 ◽  
Vol 15 (8) ◽  
pp. 2370-2374
Author(s):  
Saba Pario ◽  
Shaista Bashir Anwar ◽  
Zafar Haleem Baloch ◽  
Saira Ghafoor ◽  
Shazia Aftab ◽  
...  
Keyword(s):  
Medical Students ◽  
Undergraduate Students ◽  
Assessment Tool ◽  
Clinical Skills ◽  
Tool Material ◽  
P Value ◽  
Practical Skills ◽  
Undergraduate Medical Students ◽  
Cross Sectional ◽  
Significant Difference

OBJECTIVE: To explore the perception of undergraduate students of United Medical and dental college towards objective structured clinical examination as an assessment tool. MATERIAL & METHODS: A cross-sectional observational study included undergraduate medical students, RESULTS: 153 students who completely filled the proforma were included in study among them 31% were male and 69% were females. Mostly agreed that stations in OSCE were simple and easily interpretable and assessed practical skills thoroughly. Majority of students accepted that skills inquired were taught in clinics, stations were according to course and stations were appropriately timed. 66 % confirmed that adequate instructions were provided before exam. 84.31% believed that OSCE is preferable to viva. 57.51% of candidates stated that examiners during OSCE were attentive and gracious but 20.91 % objected it , while 21.57% remained neutral. Almost half of examinees labelled it as comprehensive clinical assessment .Overall, 67.97 % perceived OSCE as demanding and tough assessment. Finally views of students for statement that OSCE is unbiased, reliable and valid were positive in 50.32%.There was a significant difference in the opinion of male and female( p-value is less than 0.05) in statement that OSCE thoroughly assessed practical skills, stations were according to course of instruction, Adequate instructions were provided before exam, superior and preferable to viva, assists in improvement of clinical skills, demanding and tough and finally OSCE was unbiased, reliable and valid CONCLUSION: OSCE was perceived as fair, comprehensive, un-biased format of examination but believed it was more stressful than traditional examination methods . KEY WORDS: Assessment, Attitude, OSCE, Perception, Undergraduate Medical students.

scholarly journals Objective structured practical examination as a formative assessment tool compared to traditional method for third year M.B.B.S. community medicine students

2019 ◽  
Vol 6 (10) ◽  
pp. 4285
Author(s):  
Archana Carolin ◽  
Prathyusha Tirupati Venkata Devi
Keyword(s):  
Formative Assessment ◽  
Traditional Method ◽  
Assessment Tool ◽  
Clinical Skills ◽  
Conventional System ◽  
Cross Sectional ◽  
Uniform System ◽  
Practical Examination ◽  
Practical Evaluation ◽  
Effective Assessment

Background: Assessment of students in medical colleges was done by traditional practical examination for evaluation of practical or clinical skills, which is subjective in nature and suffer from lack of objectivity. So a uniform system of clinical and practical evaluation of medical students is always desirable. An objective structured practical examination (OSPE) is one such method believed to meet the deficiencies of the conventional system of practical/clinical examination. This study is an attempt to evaluate the effectiveness of OSPE as a formative assessment tool compared to traditional methods for M.B.B.S. students.Methods: A cross sectional comparative study was carried out on 56 MBBS students in KAMSRC, Hyderabad, Telangana. Students of 3rd year M.B.B.S were subjected to traditional practical evaluation followed by OSPE. A eight station OSPE was conducted one week after the TPE. The scores obtained in both were compared. All the data collected was entered and analyzed with MS excel software 2007.Results: Average marks scored by the students in OSPE (17.78±2.69) were higher as compared to traditional practical examination (15.00±3.49) which was statistically significant. 74.4% of the students strongly agreed that OSPE is fairer in comparison to traditional practical examination. 90.5% students strongly agreed that variability of examiner and patient can be removed to a large extent by OSPE.Conclusions: Based on the observation, OSPE was found to be a more effective assessment tool than traditional method.

scholarly journals The Role of Conservative Management in Treatment of Critical Limb Ischemia

2020 ◽  
Author(s):  
Sara Mohamed ◽  
Deirdre C Mc Dermott ◽  
Khalid Ahmed ◽  
Veronica McInerney ◽  
Linda Howard ◽  
...  
Keyword(s):  
Conservative Management ◽  
Critical Limb Ischemia ◽  
Statistical Significance ◽  
Phase 1 ◽  
Limb Ischemia ◽  
P Value ◽  
High Morbidity ◽  
Conservative Group ◽  
Kaplan Meier ◽  
One Year

Background: Revascularization has been considered the gold standard treatment for critical limb ischemia (CLI). Due to the high morbidity and mortality associated with intervention, evidence has emerged recently supporting the suitability of conservative management as a primary option to achieve amputation-free survival (AFS) in CLI patients even when revascularization is technically feasible. Methods: A prospective database of CLI patients was developed during pre-screening of patients for a phase 1 stem cell therapy clinical trial. The overall survival (OS) and AFS rates for patients treated with revascularization were compared to those treated conservatively. Statistical significance was set as p value < 0.05. OS and AFS for the two groups were estimated by Kaplan-Meier survival curves. Results: Patients in the conservative group were more likely to have Rutherford Class 5 and be diabetic while they were less likely to be active smokers or have hyperlipidemia (Table 1). There were no significant differences between the two groups in mortality, amputation, overall AFS or one-year AFS rates. Kaplan-Meier cumulative OS and AFS over the 3 years follow-up period of the study demonstrated significant differences between the conservative and revascularization groups (Log Rank: 0.031 & 0.045; respectively). This statistical significance was not detected when one-year AFS was evaluated (Log Rank 0.096). Conclusion: Conservative management can be a suitable management option to achieve one-year AFS for some CLI patients. Further studies are needed to identify robust clinical criteria for identifying patients who will benefit from conservative management.

scholarly journals A STUDY ON CLINICAL EVALUATION OF DIABETIC RETINOPATHY AND ITS CORRELATION WITH SERUM HbA1c LEVEL

2021 ◽  
pp. 136-138
Author(s):  
Debasmita Mishra ◽  
Deshish Kumar Panda ◽  
Prasant Kumar Nanda ◽  
Saiprasanna Behera
Keyword(s):  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Clinical Evaluation ◽  
Hba1c Level ◽  
P Value ◽  
Cross Sectional ◽  
Medical College ◽  
Eta Squared ◽  
The Mean ◽  
One Year

This cross-sectional clinical study titled “A clinical evaluation of diabetic retinopathy and its correlation with serum HbA1c level”was conducted in Hi-Tech medical college,Bhubaneswar from September 2019 to May 2021 by taking 67 patients from ophthalmological OPD who were diagnosed as cases of diabetic retinopathy,but not taking laser therapy and not having other non-diabetic causes of retinal degeneration and having diabetic mellitus of at least one year without considering type of diabetes or treatment taken by the patients.These 67 patients diagnosed as cases of diabetic retinopathy are classified according to their severity basing upon their findings( microaneurysm, exudates, retinal hemorrhages, venous beading , IRMA, new vessels in disc or elsewhere in retina) as per ETDRS(Abbreviated early treatment diabetic retinopathy study) classification as mild NPDR, moderate NPDR, severe NPDR, very severe NPDR, PDR. Their serum glycosylated haemoglobin (HbA1c) level of each individual in each group is detected and then mean HbA1c level of each group derived and when correlated ,we found that the mean HbA1c for mild grade of retinopathy was found to be 7.667,for moderate non-proliferative diabetic retinopathy(NPDR) 8.450,for severe NPDR 9.700,for very severe NPDR 11.447 and for Proliferative Diabetic Retinopathy(PDR) the mean HbA1c value was found to be 11.468.The P value obtained through ANOVA test for HbA1c vs. grade of diabetic retinopathy was statistically significant (Sig : 0.000).The Eta & Eta squared value for HbA1c vs grade of retinopathy was 0.695 and 0.483.So the present study reveals that more severe grades of diabetic retinopathy manifesting in patients with higher levels of HbA1c

Perception of Faculty Members in Clinical and Surgical Departments on Mini-CEX as an Assessment Tool for Undergraduate Students in a Medical College in Central Kerala

2021 ◽  
Vol 8 (29) ◽  
pp. 2661-2666
Author(s):  
Menon Narayanankutty Sunilkumar
Keyword(s):  
Standard Deviation ◽  
Formative Assessment ◽  
Undergraduate Students ◽  
Assessment Tool ◽  
Clinical Skills ◽  
Assessment Method ◽  
Faculty Members ◽  
Work Place ◽  
Medical College ◽  
College Setting

BACKGROUND The Mini-CEX (Mini clinical examination exercise) is a work place based assessment (WPBA) method used for the assessment of clinical skills. The present study attempts to study the different perceptions of faculty members of clinical and surgical departments in the medical college in using Mini-CEX as an assessment method in undergraduate students. METHODS This was a descriptive study done at Amala Institute of Medical Sciences, Thrissur for a period of three months.30 faculty members from various departments were requested to conduct the Mini-CEX sessions in their departments and these faculty members were assessed by another Observer from the same department. RESULTS The sample size was thirty. The faculty members with different experience levels were included in the study. They were also the observers mutually. The Mini-CEX was conducted in the hospital premises. The location varied. The duration of the Mini-CEX for a particular skill was noted in minutes. The mean in all 3 skills is around 7.9 with a standard deviation of about 1.2.This shows that the Mini-CEX duration is only about 6 to 8 minutes. The data reveals a mean of 5 minutes with a standard deviation of 1.0 for the feedback session. So in effect the whole session of Mini-CEX was over by about 11 to 13 minutes which is not a lengthy assessment session. 5 point Likert scale was used to analyse the perceptions of the faculty members in the role of examiner and observer as well. The results showed that Mini-CEX is feasible in the medical college setting and can be used for the formative assessment of undergraduate students. CONCLUSIONS Mini-CEX is well appreciated and valued by the examiner for assessment of undergraduate students. Direct observation of medical trainees with actual patients and Mini-CEX during busy clinical postings is feasible with good outcomes. Mini-CEX can be used for the formative assessment of undergraduate students. KEYWORDS WPBA, Mini-CEX, Faculty Perception, Undergraduate Students

scholarly journals P050: How aware is safe enough? Situational awareness is higher in safer teams doing simulated emergency airway cases

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S74-S74
Author(s):  
J.P. French ◽  
D. Maclean ◽  
J. Fraser ◽  
S. Benjamin ◽  
P. Atkinson
Keyword(s):  
Airway Management ◽  
New Brunswick ◽  
Emergency Departments ◽  
Situational Awareness ◽  
Assessment Tool ◽  
Statistical Significance ◽  
P Value ◽  
Multidisciplinary Teams ◽  
Operational Environment ◽  
Emergency Airway

Introduction: Situational Awareness is the ability to identify, process, and comprehend the critical elements of information about the patient condition, stability, the operational environment and an appropriate clinical course. The Situational Awareness Global Assessment Tool (SAGAT) is a validated tool for measuring situational awareness. The SAGAT tool was measured during a series of standardized high fidelity advanced airway management simulations in multidisciplinary teams in New Brunswick Emergency Departments delivered by two simulation programs Methods: Thirty eight simulated emergency airway cases were performed in situ in Emergency Departments and in learning centers in Southern New Brunswick from September 2015 to October 2017. Eight standardized cases were used whose educational objectives were to develop the optimization of critically ill patients prior to induction, to deliver patient-centered anesthesia and to choose an appropriate airway strategy. Learner profiles collected. Cases were divided into two groups; those that contained critical errors and those that did not based on video assessment. Critical errors were defined as failure of 1) Oxygenation 2) Shock correction 3) Induction dose estimation 4) Choice of airway management paradigm. The SAGAT has a maximum score of 13 and was assessed by research nurses after each case for all participants. SAGAT scores were non-normally distributed, so results were expressed as medians with interquartile ranges. Mann Whitney U tests were used to calculate statistical significance. Results: Results. Of the 38 cases, 14 contained one more critical errors. The median SAGAT score in the group that contained critical errors was 8 +/− 2 (IQR). The median SAGAT Score in the group that contained no critical errors was 11 +/− 2 (IQR). The median scores we significantly different with a p-value of 0.02. Conclusion: In this study in simulated emergency cases, higher SAGAT scores were associated with teams leaders that did not commit safety critical errors. This work is the initial analysis to develop standards for Simulated team performance in Emergency Department teams.

scholarly journals Objective Assessment of Microsurgery Competency—In Search of a Validated Tool

2019 ◽  
Vol 52 (02) ◽  
pp. 216-221
Author(s):  
Sheeja Rajan ◽  
Ranjith Sathyan ◽  
L. S. Sreelesh ◽  
Anu Anto Kallerey ◽  
Aarathy Antharjanam ◽  
...  
Keyword(s):  
Skill Acquisition ◽  
Convergent Validity ◽  
Assessment Tool ◽  
Objective Assessment ◽  
Reliability And Validity ◽  
Assessment Tools ◽  
Skill Assessment ◽  
P Value ◽  
Global Rating ◽  
Skills Acquisition

AbstractMicrosurgical skill acquisition is an integral component of training in plastic surgery. Current microsurgical training is based on the subjective Halstedian model. An ideal microsurgery assessment tool should be able to deconstruct all the subskills of microsurgery and assess them objectively and reliably. For our study, to analyze the feasibility, reliability, and validity of microsurgery skill assessment, a video-based objective structured assessment of technical skill tool was chosen. Two blinded experts evaluated 40 videos of six residents performing microsurgical anastomosis for arteriovenous fistula surgery. The generic Reznick's global rating score (GRS) and University of Western Ontario microsurgical skills acquisition/assessment (UWOMSA) instrument were used as checklists. Correlation coefficients of 0.75 to 0.80 (UWOMSA) and 0.71 to 0.77 (GRS) for interrater and intrarater reliability showed that the assessment tools were reliable. Convergent validity of the UWOMSA tool with the prevalidated GRS tool showed good agreement. The mean improvement of scores with years of residency was measured with analysis of variance. Both UWOMSA (p-value: 0.034) and GRS (p-value: 0.037) demonstrated significant improvement in scores from postgraduate year 1 (PGY1) to PGY2 and a less marked improvement from PGY2 to PGY3. We conclude that objective assessment of microsurgical skills in an actual clinical setting is feasible. Tools like UWOMSA are valid and reliable for microsurgery assessment and provide feedback to chart progression of learning. Acceptance and validation of such objective assessments will help to improve training and bring uniformity to microsurgery education.

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