mini-cex and dops: why and how? - cobatrice · mini-cex / dops • no stand alone • part of an...

Institut für Medizinische Lehre

Mini-CEX and DOPS: Why and How?

Christoph Berendonk MD MME

[email protected]

mailto:[email protected]


Content

Why

How

• Principles of the two instruments

• Thoughts on implementation

www.vaxd.com


Mini-CEX / DOPS

Mini-CEX Mini-Clinical Evaluation Exercise

History taking, counseling, physical examination

DOPS Direct Observation of Procedures

Technical interventions

Resident-Patient-Interaction


Why Mini-CEX / DOPS

• Extrinsic effect

„we learn what is tested“

• Intrinsic effect

„what is being tested is better stored“

assessment drives learning

test-enhanced learning


Test enhanced learning

73.3

82.8

5 0

7 5

1 0 0

Posttest 14 d nach Kurs

4 h Kurs

3.5 h Kurs +30 Min Test

p< 0 .0 0 1

ES= 0 .9 3

%

• 5th year medical students

• ACLS course

• 30 min theory

• 3 h practice

• Experiment

• Control: 30 min further practice

• Intervention: 30 min test

Kromann. Med Educ 2009

14 days later

4 h course

3.5 h course

+ 0.5 h test


Why Mini-CEX / DOPS

adapted from John Norcini, Workshop „Research in Medical Educations“, Heidelberg 2009

Medical Expert

Communicator Collaborator Health Advocate

Manager Scholar Professional

1. Written Tests (MCQ, SAQ) +++ + ++ ++ + ++ +

2. Essays ++ + + +++ + + +

3. Oral Exam +++ + + + - - +

4. Mini-CEX / DOPS

+++ +++ +++ +++ +++ +++ +++

5. OSCE / SP +++ +++ +++ ++ - - +

6. Multi-source Feedback ++ +++ +++ +++ +++ ++ +++

7. Portfolio ++ ++ + +++ ++ +++ +++

8. Simulations +++ + +++ - ++ - ++


Mini-CEX / DOPS

Observation Documentation Feedback


Mini-CEX / DOPS

Observation 10-15 Min

• “We have learned many surprising things about our residents‘ skills and deficiencies not evident at morning report, rounds, or via standardized tests”

• “We also learned that the skills that cause a resident to shine on rounds, such as verbal case presentations and transmission of didactic material, do not necessarily correlate with clinical skills “

ABIM


Mini-CEX / DOPS

Documentation


Mini-CEX / DOPS

Feedback 5 Min

motor-talk.de


Feedback Effects

15.4 15.917

22

0

5

10

15

20

25

30

Unspez. Feedback Konstrukives Feedback

Pretest

Posttest

p post= 0 .0 0 8

ppre= 0 .8 2

• 3rd year medical students

• surgical knot tying course

• 30 min theory

• pre-test

• practical exercise

• Control: unspecific feedback

• Intervention: specific feedback

• post-test

Boehler. Med Educ 2006

Control Intervention


Feedback

• is planed and expected

• includes a self-assessment

• addresses points of improvement and strengths

• is specific and describes

• focuses on modifiable behaviour

• includes a jointly developed learning goal

adapted from Ende. Jama 1983


Thoughts on implementation

Mini-CEX / DOPS

• No stand alone

• Part of an educational program

‘Blockpraktika’ Master of

Medicine, Bern University

• 5 clinical rotations each lasting one month

• Bed side teaching

• Case based discussions

• Patient retinue

• …

• One Mini-CEX / DOPS

per student per week

• Final evaluation at the end of each rotation



Mini-CEX / DOPS



• Students get regular and systematic feedback about their performance

• Early identification of students ‘with problems’


Mini-CEX / DOPS



Mini-CEX / DOPS

• Inform all stakeholders about purpose

• Giving feedback is a skill



• Information:

• face to face

• leaflet

• www

• Teach the teacher workshops

• Hands on practical experience


Results of cohort 2010

• Feasibility

• 2115 Mini-CEX / DOPS with 141 students

• Number of Mini-CEX / DOPS per student: 15 mean (SD +/- 2.5)

• Response rate: 94%

• Narrative comments

• About 60% of the assessment forms contained information about strengths and weaknesses

• About 40% included specific learning goals


Conclusions

• Mini-CEX / DOPS contribute to the educational quality of medical programs

• Adapt the tool for your needs

• Giving and receiving feedback is a skill

mini-cex and dops: why and how? - cobatrice · mini-cex / dops • no stand alone • part of an...

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