Mini-Clinical Examination (Mini-Cex) As a Formative Assessment Tool for Ent Interns at Aniims

Abstract

Background: Competency-based medical education (CBME) requires robust formative assessments that provide structured feedback and encourage reflective practice. The mini-Clinical Evaluation Exercise (mini-CEX) is a validated workplace-based assessment tool, though its utility in ENT training in India remains underexplored.

Aim: To evaluate the effectiveness, feasibility, and acceptability of the mini-CEX as a formative assessment tool for ENT interns at ANIIMS.

Methods: A prospective cross-sectional study was conducted among 50 ENT interns over fmonths. Each intern underwent multiple mini-CEX encounters across outpatient, inpatient, and emergency settings. Seven domains—medical interviewing, physical examination, professionalism, clinical judgment, counseling, organization/efficiency, and overall competence—were assessed using a 9-point scale. Pre- and post-intervention scores were compared using paired t-tests, with 95% confidence intervals and p-values calculated. Intern and faculty feedback on feasibility and acceptability was also obtained.

Results: Mean overall competence improved significantly from 5.0 ± 0.8 to 7.2 ± 0.7 (Δ=2.2, p<0.001). The proportion of interns rated “Superior” (≥7) increased from 4% to 56%. All domains showed significant post-intervention improvements, with mean gains ranging from +1.8 to +2.2 points (p<0.001). Feasibility analysis revealed an average of 3.2 encounters per intern, mea

n time of 16.4 minutes per encounter, and high levels of satisfaction (74% overall satisfied; 90% valued feedback). Conclusion: The mini-CEX significantly enhanced clinical competence, communication, and professionalism of ENT interns at ANIIMS. It was feasible, well-accepted, and time-efficient, supporting its integration into CBME frameworks for ENT training in resource-limited medical institutions.