Implementation of Mini-Clinical Evaluation Exercise (Mini-CEX) in Ophthalmology Clerkship: A Medical Education Experience from Islamabad, Pakistan

Abstract

Objective: To evaluate the implementation and educational utility of the Mini-Clinical Evaluation Exercise (Mini-CEX) as a workplace-based assessment (WPBA) tool during undergraduate ophthalmology clerkship programme.

Methods: This educational interventional study was conducted at the Department of Ophthalmology, Islamabad Medical and Dental College (IMDC), Islamabad, Pakistan, from January to December 2024. A total of 100 fourth-year MBBS students undergoing ophthalmology clerkship were included using non-probability consecutive sampling. Students were divided into five clerkship rotation groups and underwent three Mini-CEX encounters during clinical rotations. Clinical competence was assessed across multiple domains including history taking, examination skills, communication, professionalism, and clinical judgment using a standardized 9-point Mini-CEX scale. Student and faculty perceptions regarding Mini-CEX were also evaluated using structured questionnaires.

Results: The mean overall Mini-CEX score significantly improved from 5.8 ± 0.9 during the first encounter to 7.5 ± 0.7 during the third encounter (p=0.001). Significant improvement was observed across all clinical domains, particularly communication skills and professionalism. Immediate feedback was considered beneficial by 95% of students, while 93% recommended continued Mini-CEX implementation during ophthalmology clerkship. Faculty members also reported high satisfaction regarding educational utility and feasibility. A significant positive correlation was observed between feedback quality and improvement in clinical competence scores (r=0.62, p=0.001).

Conclusion: Mini-CEX was found to be an effective and feasible workplace-based formative assessment tool during undergraduate ophthalmology clerkship. Repeated direct observation and structured feedback significantly improved students’ clinical competence, communication skills, and professional development.