文章基本信息

标题：The influence of students’ prior clinical skills and context characteristics on mini-CEX scores in clerkships – a multilevel analysis
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作者：Anja Rogausch ; Christine Beyeler ; Stephanie Montagne 等
期刊名称：BMC Medical Education
印刷版ISSN：1472-6920
出版年度：2015
卷号：15
期号：1
页码：208-217
DOI：10.1186/s12909-015-0490-3
出版社：BioMed Central
摘要：In 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. Medical 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. A 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. In 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.
关键词：Clinical Competence ; Educational measurement ; Education ; Medical ; Undergraduate ; Task Performance and analysis ; Workplace ; Clinical clerkship ; Psychometrics