Mini-CEX and DOPS: Why and How?
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1 Mini-CEX and DOPS: Why and How? Christoph Berendonk MD MME
2 Content Why How Principles of the two instruments Thoughts on implementation
3 Mini-CEX / DOPS Resident-Patient-Interaction Mini-CEX Mini-Clinical Evaluation Exercise DOPS Direct Observation of Procedures History taking, counseling, physical examination Technical interventions
4 Why Mini-CEX / DOPS Extrinsic effect we learn what is tested assessment drives learning Intrinsic effect what is being tested is better stored test-enhanced learning
5 Test enhanced learning 5th year medical students ACLS course 30 min theory 3 h practice Experiment Control: 30 min further practice Intervention: 30 min test % p< ES= Posttest 14 d nach Kurs 14 days later 4 h Kurs 4 h course 3.5 h Kurs + 30 Min Test 3.5 h course h test Kromann. Med Educ 2009
6 Why Mini-CEX / DOPS Medical Expert Communicator Collaborator Health Advocate Manager Scholar Professional 1. Written Tests (MCQ, SAQ) Essays Oral Exam Mini-CEX / DOPS OSCE / SP Multi-source Feedback Portfolio Simulations adapted from John Norcini, Workshop Research in Medical Educations, Heidelberg 2009
7 Mini-CEX / DOPS Observation Documentation Feedback
8 Mini-CEX / DOPS Observation 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
9 Mini-CEX / DOPS Documentation
10 Mini-CEX / DOPS Feedback 5 Min motor-talk.de
11 Feedback Effects 3rd year medical students surgical knot tying course 30 min theory pre-test practical exercise Control: unspecific feedback Intervention: specific feedback post-test Control Unspez. Feedback p pre = p post = Intervention Konstrukives Feedback Pretest Posttest Boehler. Med Educ 2006
12 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
13 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
14 Thoughts on implementation Mini-CEX / DOPS Blockpraktika Master of Medicine, Bern University Students get regular and systematic feedback about their performance Early identification of students with problems
15 Mini-CEX / DOPS
16 Thoughts on implementation Mini-CEX / DOPS Inform all stakeholders about purpose Giving feedback is a skill Blockpraktika Master of Medicine, Bern University Information: face to face leaflet www Teach the teacher workshops Hands on practical experience
17 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
18 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
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