MINI-CEX INSTRUCTIONS FOR USE GENERAL INFORMATION

WHAT IS THE MINI-CEX? The Mini CEX involves the trainee being observed in an encounter with a patient and rated by an assessor (the clinical supervisor) on a number of dimensions. This is a work-based, in-training assessment which involves rating the trainee on an activity which already occurs in current training such as seeing a patient in the clinic. Immediate feedback is provided to the trainee and is the most important part of the exercise.

WHO SHOULD I ASK TO BE AN ASSESSOR? You should ask any Clinical Supervisor or Director of Training to conduct a mini-CEX for you. Assessors need not have had contact with you previously in order to be a mini-CEX assessor. The mini-CEX can take place in the ward, clinic, in radiation treatment, during treatment planning or in other suitable clinical contexts. Assessors conducting a mini-CEX should have undertaken the mini-CEX training provided by their training site.

HOW SHOULD IT WORK? Verbal patient consent should be sought before the assessment commences. You should lead the assessment you have chosen to have this assessment of this clinical encounter. The observed encounter should take no longer than 15-20 minutes (maybe slightly longer if a new patient is being assessed). Feedback should take no longer than 5-10 minutes.

WHAT DO I DO WITH THE FORM? The form should be signed by you and your assessor, dated, and the original given back to you for inclusion in your Learning Portfolio. The Assessor then enters the completed Mini-CEX online by clicking on the following link: https://www.surveymonkey.com/s/THHX389

WHY DOES THE INFORMATION HAVE TO BE COMPLETED ONLINE? The reason for this is to allow tracking of trainee performance over time and collection of data on patient problem/DX, Patients Age, Problem Complexity and Patient Location. The information collected can be analysed and used to inform improvements to the new Radiation Oncology Training Program Curriculum.
_________________________________________________________________________________________ Education and Research Portfolio Learning Portfolio, Section 3: Assessments, Mini-CEX, Instructions, Version 3, September 2010 The Royal Australian and New Zealand College of Radiologists 2010

COMPLETING THE FORM

SPECIFIC POINTS Note: not all sections of the form need to be completed in one clinical encounter. Please ensure that your name, year of training, your assessors name and the date are recorded at the top of the form. Assessors should also ensure that a patient diagnosis/problem, the complexity of the case and the location of the assessment at the top of the form are completed.

INCLUSION IN YOUR LEARNING PORTFOLIO You should include all attempts at mini-CEXs in your Learning Portfolio and enter the data online by clicking on the following link: https://www.surveymonkey.com/s/THHX389

FEEDBACK The primary aim of the mini-CEX is to provide feedback on your performance. Your assessor should comment on areas of strength, areas which could be improved upon and you should develop an action plan as to how you might improve these aspects of your performance.

_________________________________________________________________________________________ Education and Research Portfolio Learning Portfolio, Section 3: Assessments, Mini-CEX, Instructions, Version 3, September 2010 The Royal Australian and New Zealand College of Radiologists 2010

MINI-CEX DOCUMENTATION

Trainee requests a mini-CEX assessment

Assessor observes trainee conducting the mini-CEX, completes the form and provides feedback to the trainee

The Assessor should provide a copy of the completed mini-CEX to the DOT and return the original to the trainee

Assessor or DoT enters information from the completed mini-CEX online https://www.surveymonkey.com/s/ THHX389

Trainee includes completed miniCEX in Learning Portfolio

_________________________________________________________________________________________ Education and Research Portfolio Learning Portfolio, Section 3: Assessments, Mini-CEX, Flowchart, Version 3, September 2010 The Royal Australian and New Zealand College of Radiologists 2010

RANZCR Mini-CEX ASSESSMENT FORM

TRAINEE ASSESSOR PATIENT PROBLEM/DX PROBLME COMPLEXITY PATIENT LOCATION Low Ward Moderate Clinic High Planning On Treatment YEAR OF TRAINING AGE GENDER

Other (specify) 1. MEDICAL INTERVIEWING SKILLS (__ Not observed) 1 2 3 4 5

Satisfactory

Unsatisfactory

Above expected

2. PHYSICAL EXAMINATION SKILLS (__ Not observed) 1 2 3 4 5

Satisfactory

Unsatisfactory

Above expected

3. PROFESSIONALISM/HUMANISTIC QUALITIES (__ Not observed) 1 2 3 4 5

Satisfactory

Unsatisfactory

Above expected

4. COUNSELLING SKILLS (__ Not observed) 1 2 3 4 5

Satisfactory

Unsatisfactory

Above expected

5. CLINICAL JUDGEMENT (__ Not observed) 1 2 3 4 5

Satisfactory

Unsatisfactory

Above expected

6. ORGANISATION/EFFICIENCY (__ Not observed) 1 2 3 4 5

Satisfactory

Unsatisfactory

Above expected

OVERALL CLINICAL COMPETENCE 1 2 3 4 5

Satisfactory

Unsatisfactory

Above expected

Time observing

______ minutes

Time providing feedback ______minutes

This case adequately tested the trainees abilities: COMMENTS ON TRAINEES PERFORMANCE

Yes

No

Trainees Signature

Assessors Signature

Date

_________________________________________________________________________________________ Education and Research Portfolio Learning Portfolio, Section 3: Assessments, Mini-Clinical Evaluation, Mini-CEX Tool, Version 2, 22 February 2010 The Royal Australian and New Zealand College of Radiologists 2010

DESCRIPTORS OF COMPETENCIES ASSESSED DURING THE MINI-CEX

1. Medical Interviewing Skills: Facilitates patients telling of story; effectively uses questions/directions to obtain accurate, adequate information needed; responds appropriately to affect, non-verbal cues; identifies and explores the patients issues and concerns within the scope of a focused consultation 2. Physical Examination Skills: Follows efficient, logical sequence; balances screening/diagnostic steps for problem; informs patient; sensitive to patients comfort, modesty. 3. Professionalism/Humanistic Qualities: Shows respect, compassion, empathy, establishes trust, attends to patients needs of comfort, confidentiality, modesty. 4. Counselling Skills: Explains rationale for test/treatment, obtains patients consent, educates/counsels regarding management. Where appropriate explains the natural history of the cancer including prognosis and treatment options. 5. Clinical Judgement: Selectively orders/performs appropriate diagnostic studies, considers risks, benefits; interprets clinical investigations and synthesise these with patient history and symptoms; justifies treatment recommendations, based on current evidence, multidisciplinary advice and relevant patient-related factors. 6. Organization/Efficiency: Prioritises; is timely, succinct. 7. Overall Clinical Competence: efficiency. Demonstrates judgment, synthesis, caring, effectiveness,

Adapted from ABIM mini-CEX, Norcini JJ et al, 2003

_________________________________________________________________________________________ Education and Research Portfolio Learning Portfolio, Section 3: Assessments, Mini-Clinical Evaluation, Mini-CEX Tool, Version 2, 22 February 2010 The Royal Australian and New Zealand College of Radiologists 2010

REFERENCES AND FURTHER READING

Bandiera G, Sherbino J, Frank JR. The CanMEDS assessment tools handbook. An introductory guide to assessment methods for the CanMEDS competencies. Ottowa: The Royal College of Physicians and Surgeons of Canada; 2006. Review of work-based assessment methods. Centre for Innovation in Professional Health Education and Research, The University of Sydney, Australia. 2007. Fernando N, Cleland J, McKenzie H, Cassar K. Identifying the factors that determine feedback given to undergraduate medical students following formative mini-CEX assessments. Medical Education 2008; 42:89-95. Norcini JJ, Blank LL, Duffy D, Fortna GS. The mini-CEX: a method for assessing clinical skills. Annals of Internal Medicine 2003; 138:476-481.

_________________________________________________________________________________________ Education and Research Portfolio Learning Portfolio, Section 3: Assessments, Mini-CEX, References, Version 2, 22 February 2010 The Royal Australian and New Zealand College of Radiologists 2010