The Utility of the Mini-Clinical Evaluation Exercise (Mini-CEX) in the Emergency Department: A Systematic Review and Meta-Analysis Evaluating the Readability, Feasibility, and Acceptability of Mini-CEX Utilization

Hany A Zaki; Yavuz Yigit; Eman Shaban; Ahmed E Shaban; Amr Elmoheen; Khalid Bashir; Kaleem Basharat; Mohamed Ali; Baha Hamdi Alkahlout

doi:10.7759/cureus.44443

The Utility of the Mini-Clinical Evaluation Exercise (Mini-CEX) in the Emergency Department: A Systematic Review and Meta-Analysis Evaluating the Readability, Feasibility, and Acceptability of Mini-CEX Utilization

Cureus. 2023 Aug 31;15(8):e44443. doi: 10.7759/cureus.44443. eCollection 2023 Aug.

Authors

Hany A Zaki¹, Yavuz Yigit^{2

1}, Eman Shaban³, Ahmed E Shaban^{4

5}, Amr Elmoheen¹, Khalid Bashir^{6

1}, Kaleem Basharat¹, Mohamed Ali¹, Baha Hamdi Alkahlout¹

Affiliations

¹ Emergency Medicine, Hamad Medical Corporation, Doha, QAT.
² Blizard Institute, Queen Mary University, London, GBR.
³ Cardiology, Al Jufairi Diagnosis and Treatment, Doha, QAT.
⁴ Internal Medicine, Mansoura General Hospital, Mansoura, EGY.
⁵ Medicine, Mansoura University Faculty of Medicine, Mansoura, EGY.
⁶ Medicine, Qatar University, Doha, QAT.

Abstract

Assessment tools, such as the mini-clinical evaluation exercise (mini-CEX), have been developed to evaluate the competence of medical trainees during routine duties. However, their effectiveness in busy environments, such as the emergency department (ED), is poorly understood. This study assesses the feasibility, reliability, and acceptability of implementing the mini-CEX in the ED. PubMed, Google Scholar, ScienceDirect, Scopus, and Web of Science databases were scoured for observational and randomized trials related to our topic. Moreover, a manual search was also conducted to identify additional studies. After the literature search, data were extracted from studies that were eligible for inclusion by two independent reviewers. When applicable, meta-analyses were performed using the Comprehensive Meta-Analysis software. In addition, the methodological quality of studies was evaluated using the Newcastle-Ottawa Scale. Of the 2,105 articles gathered through database and manual searches, only four met the criteria for inclusion in the review. A combined analysis of three studies revealed that trainee-patient interactions averaged 16.05 minutes (95% CI = 14.21-17.88), and feedback was given in about 10.78 minutes (95% CI = 10.19-11.38). The completion rates for mini-CEX were high: 95.7% (95% CI = 87.6-98.6) for medical trainees and 95.8% (95% CI = 89.7-98.3) for assessors. Satisfaction with mini-CEX was notable, with 63.5% (95% CI = 51.5-74.1) of medical trainees and 75.7% (95% CI = 63.9-84.6) of assessors expressing contentment. Qualitative data from one study demonstrated that 70.6% of faculty members could allocate suitable time for mini-CEX during their clinical shifts. The mini-CEX is a feasible and acceptable assessment tool within the ED. Furthermore, there is evidence to suggest that it might be reliable.

Keywords: acceptability; emergency department; feasibility; mini-cex; mini-clinical evaluation exercise; mini-clinical examination; mini-evaluation exercise; modified mini-cex; reliability; satisfaction.

Publication types

Review