Araştırma Makalesi
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MİNİ KLİNİK DEĞERLENDİRME (MINI-CEX) YÖNTEMİNİN PSİKOMETRİK ÖZELLİKLERİNİN VE KULLANIŞLILIĞININ DEĞERLENDİRİLMESİ “EGE ÜNİVERSİTESİ TIP FAKÜLTESİ ÖRNEĞİ”

Yıl 2017, Cilt: 16 Sayı: 49, 5 - 17, 30.09.2017

Öz

Bu araştırma ile Ege Üniversitesi Tıp Fakültesinde
mezuniyet öncesi dönemde öğrencilerin mesleksel performanslarını
değerlendirmede Mini klinik değerlendirme (mini-CEX) formunun uyarlanması ve kullanışlılığının
ortaya konulması amaçlanmıştır.

Araştırmada karma model açıklayıcı deseni kullanılmıştır.
Araştırmanın nicel verileri, mini-CEX formu kullanılarak üç hafta ve üzeri
süreli klinik stajlardan toplanmıştır. Araştırma verileri 2010-2011 eğitim
öğretim döneminde klinik eğitim dönemi gönüllü öğrenci ve öğretim üyelerinin
katılımıyla elde edilmiştir. Örneklem seçiminde “amaçsal örnekleme” yöntemi
kullanılmıştır. Formun kullanışlılığına ilişkin nitel veriler öğrencilerle
yapılan “odak grup” ve öğretim üyeleriyle yapılan “yarı yapılandırılmış
görüşme” ile toplanmıştır.

Toplam 72 mini-CEX uygulaması yapılmıştır. Formun iç
tutarlık katsayısı 0,79 bulunmuştur. Mini-CEX formunun görünüm, kapsam ve
yordama geçerlik çalışmaları yapılmıştır. Öğrencilerin staj sonu sözlü ve staj
geçme puanları ile korelasyonu sırasıyla 0,64, 0,62 bulunmuştur. Uygulamalar
ortalama 20,09 dakikada gerçekleştirilmiştir. Uygulamaların %82’si serviste, %
66,6’sı orta karmaşıklıkta hastalarda ve %33,8’i hastaya tanı koyma odaklı
olarak yapılmıştır. Uygulamada en düşük puan ortalaması 6,59 ile fizik muayene,
en yüksek puan ortalaması ise 7,45 ile insani değerler başlığında saptanmıştır.
Öğrenci ve öğretim üyelerinin uygulamaya ilişkin memnuniyet puan ortalamaları
sırasıyla 7,62 ve 7,69 dur.

Nitel verilerin değerlendirilmesinde adiliyet, öğrenmeye
katkı, öğretim üyesine bağımlılık, geribildirim, uygulama, değerlendirme
içeriği, duygular ve iletişim olmak üzere sekiz kategori saptanmıştır.
Öğrencilerle yapılan görüşmelerde önhazırlık başlığı dokuzuncu kategori olarak
saptanmıştır.

Araştırma bulguları öğrenci ve öğretim üyelerinin mini-CEX
uygulamasının adil olduğu, öğrenmeye katkı sağladığı, verilen geribildirimin
öğrenciyi geliştirdiği, öğrenci performansının yeterli bir içerikle
değerlendirildiği yönünde görüşlerinin olduğunu göstermiştir.











Sonuç olarak mini-CEX yöntemi iyi bir planlama ve öğrenci
ve öğretim üyeleri işbirliği ile klinik eğitim döneminde kullanılabilir.

Kaynakça

  • Linn, R.L., Miller, M.D., (2005). Measurement and Assessment in teaching, New Jersey.
  • Miller, G.E. (1990). The assessment of clinical skills / competence / performance. Academic Medicine, 65: 63-67.
  • Hauer, E.K., Mazotti, L.O., Hemmer, A.P., Tong, L. (2011) Faculty verbal evaluations reveal strategies used to promote medical student performance. Medical Education, 16:6354.
  • Rolfe, I.E., Sanson-Fisher, R.W. (2002). Translating learning principles into Practice. Medical Education, 36:345-352.
  • Epstein, R.M., Hundert, E.M. (2002). Defining and assessing professional competence. JAMA, 287:226-235.
  • Kogan, J.R., Holmboe, E.S., Hauer, K.E. (2009). Tools for direct observation and assessment of clinical skills of medical trainees: A systematic review. JAMA, 302:12, 1316-1326.
  • Kang, Y., Bardes, C.L., Gerber, L.M., Storey-Johnson, C. (2009). Pilot of Direct of Clinical Skills (DOCS) in a Medicine Clerkship: Feasibility and Realitionship to Clinical Performance Measures. Medical Education, 14: 1-8.
  • Davis, M.H., Karunathilake, I. (2005). The Place of Oral Examination in today's assessment systems. Medical Teacher, 27(4): 292-297.
  • Hays, R., (2008). Assessment in Medical Education: Roles for clinical teachers. The Clinical Teacher, 5: 23-27.
  • Turnbull, J., Barneveld, C. (2002). Assessment of clinical performance: in-training evaluation. In: Norman, G.R., Vleuten, C.P.M., Newble, D.I. International Handbook of Research in Medical Education, 793-810.
  • Van Der Vleuten, C.P.M. (1996). The assessment of Professional competence: developments, research and practical implications. Advances in Health Sciences Education, 1: 41-67.
  • Van Der Vleuten, C.P.M., Scherpbier, A.J.J.A., Dolmans, D.H.J.M., Schuwirth, L.W.T., Verwijnen, G.M., Wolfhagen, H.A.P. (2000). Clerkship assessment assessed. Medical Teacher, 22(6): 592-600.
  • Van Der Vleuten C.P.M., Schuwirth, L.W.T. (2005). Assessing Professional competence: from methods to programmes. Medical Education, 39: 309-317.
  • Norcini, J.J., (1995). The Mini-CEX (Clinical Evaluation Exercise): A Preliminary Investigation. Annals of Internal Medicine, 123:10, 795-799.
  • Kogan, J.R., Hauer, K.E. (2006). Brief report: Use of the mini-clinical evaluation exercise in internal medicine core clerkships. Journal of General Internal Medicine, 21: 501-502.
  • American Board of Internal Medicine, The Mini-CEX A Quality Tool In Evaluation. 2001-2002.
  • Norcini, J.J., et al., (2003). The Mini-CEX: A Method for Assessing Clinical Skills. Annals of Internal Medicine, 138:476-481.
  • Alves de Lima, A., Barrero, C., Baratta, S., Castillo Costa, Y., Bortman, G., Arabajales, J., et al. (2007). Validity, realiability, feasibility and satisfaction of the Mini-Clinical Evaluation Exercise (Mini-CEX) for cardiology residency training. Medical Teacher, 29:785-790.
  • Weller, J.M., Jolly, B., Misur, M.P., Merry, A.F., Jones, A., Crossley, J.G.M., (2009). Mini-clinical evaluation exercise in anesthesia training. British Journal of Anaesthesia, 102:633-641.
  • Sidhu, R.S., Hatala, R., Barron, S., Broudo, M., Pachev, G., Page, G. (2009). Realibility and acceptance of the mini-clinical evaluation exercise as performance assessment of practicing physicians. Academic Medicine, 84:113-115.
  • Golnik, K.C., Goldenhar, L.M., Gittinger, J.W., Lustbader, J.M. (2004). The ophthalmic Clinical Evaluation Exercise (OCEX). Ophthalmology, 111:1271-1274.
  • Lin Chaou-Shune, Te-Fa Chiu, Yen David, H.T., Chee-Fah Chong. (2012). Mini-Clinical Evaluation Exercise and Feedback on Postgraduate Trainess in the Emergency Department: A Qualitative Content Analysis. Journal of Acute Medicine, 2:1-7.
  • Kogan, J.R., Bellini, L.M., Shea, J.A. (2002). Implementation of the Mini-CEX to Evaluate Medical Students' Clinical Skills. Academic Medicine, 77:11:1156-1157.
  • Hill, F., Kendall, K., (2007). Adopting and adapting the mini-CEX as an undergraduate assessment and learning tool. The Clinical Teacher, 4:244-248.
  • Hill, F., et al., (2009). Implementing the undergraduate mini-CEX: a tailored approach at Southampton University. Medical Education, 43:326-334.
  • Tengiz, F.İ., Şahin, H. (2014). Klinikte Yeni bir Ölçme Yöntemi: Mini Klinik Değerlendirme. Tıp Eğitimi Dünyası, 39:13-18.
  • De Poy, E., Gitlin, L.N. (2004). Introduction to Research Understanding and Applying Multiple Strategies. USA: Elsevier Press.
  • Büyüköztürk, Ş., Çakmak, E.K., Akgün, Ö.E., Karadeniz, Ş., Demirel, F. (2008). Bilimsel Araştırma Yöntemleri. Ankara: Pegem Akademi.
  • Kim, S., Willetr, L.R., Noveck, H. Patel, M.S., Walker, J.A., Terregino, C.A. (2016). Implementation of a Mini-CEX Requirement Across All Third-Year Clerkships. Teaching and Learning in Medicine. 28(4):424-431.
  • Eggleton, K., Goodyear-Smith, F., Paton, L., Falloon, K., Wong, C., Lack, L., Kennelly, J., Fishman, T., Moyes, S.A. (2016). Reliability of Mini-CEX Assessment of Medical Students in General Practice Clinical Attachments. Family Medicine. 48(8):624-30.
  • Kogan, J.R., Bellini, L.M., Shea, J.A. (2003). Feasibility, reliability, and validity of the mini-clinical evaluation exercise (mCEX) in a medicine core clerkship. Academic Medicine, 78:33–35.
  • Wilkinson, J.R., Crossley, J.G.M., Wragg, A., Mills, P., Cowan, G, Wade, W. (2008). Implementing workplace-based assessment across the medical specialities in the United Kingdom. Medical Education. 42: 364-373.
  • Hauer, KE. (2000). Enhancing feedback to students using the mini-CEX. Academic Medicine. 75:542.
  • Torre, D.M., Simpson, D.E., Elnicki, D.M., Sebastian, J.L., Holmboe, E.S. (2007). Feasibility, reliability and user satisfaction with a A-based mini-CEX to evaluate the clinical skills of third-year medical students. Teaching and Learning in Medicine, 19, 271–277.
  • Ney, E.M., Shea, J.A., Kogan, J.R. (2009). Predictive Validity of the mini-Clinical Evaluation Exercise (mCEX): Do Medical Students’mCEX Ratings Correlate with Future Clinical Exam Performance? Academic Medicine. 84(10):17-20.
  • Durning, S.J., Cation, L.J., Markert, R.J., & Pangaro, L.N. (2002). Assessing the reliability and validity of the mini-clinical evaluation exercise for internal medicine residency training. Academic Medicine, 77: 900–904.
  • Norcini, J.J., Blank, L.L., Arnold, G.K., Kimball, H.R. (1997). Examiner differences in the mini-CEX. Adv Health Sci Educ Theory Pract. 2:27–33.
  • Nair, BR, Alexander, HG, Mcgrath, BP, Parvathy, MS, Kilsby, EC, Wenzel, J, Frank, IB, Pachev, GS, Page, GG. (2008). The mini clinical evaluation exercise (mini-CEX) for assessing clinical performance of international medical graduates. Medical Journal of Australia. 189(3):159–161.
  • Holmboe, ES., Huot, S., Chung, J., Norcini, J., Hawkins, RE. (2003). Construct validity of the miniclinical evaluation exercise (miniCEX). Academic Medicine.78:826–830.
  • Pernar, L.I.M., Peyre, S.E., Warren, L.E.G., Gu, X., Lipsitz, S., Alexander, E.K., Ashley, S.W., Breen, E.M. (2011). Mini-clinical evaluation exercise as a student assesment tool in a surgery clerkship: Lessons learned from a 5-year experience. Surgery 150 (2):272-277.
  • Hatala, R., Ainslie, M., Kassen, B. O., Mackie, I., Roberts, J. M. (2006). Assessing the mini-clinical evaluation exercise in comparison to a national specialty examination. Medical Education. 40:950–956.
  • Malhotra S, Hatala R, Courneya CA. (2008). Internal medicine residents’ perceptions of the Mini-Clinical Evaluation Exercise. Medical Teacher. 30:414-419.
  • Holmboe, ES. (2004). Faculty and the Observation of Trainees’ Clinical Skills: Problems and Opportunities. Academic Medicine. 79:16-22.
  • Alves de Lima A, Henquin R, Thierer J, Paulin J, Lamari S, Belcastro F, Van der Vleuten CPM. (2005). A qualitative study of the impact on learning of the mini clinical evaluation exercise in postgraduate training. Medical Teacher 27:46–52.
  • Brazil, V. Ratcliffe, L. Zhang, J. Davin, L. (2012). Mini-CEX as a workplace-based assessment tool for interns in an emergency department – Does cost outweigh value? Medical Teacher. 34;12: 1017-1023.
  • Norcini, J.J. (2010). The Power of Feedback. Medical Education. 44:16-17.
  • Holmboe, E.S., Yepes, M., Williams, F., Huot, S. (2004). Feedback and The Mini Clinical Evaluation Exercise. J Gen Internal Medicine. 19:558-561.
Yıl 2017, Cilt: 16 Sayı: 49, 5 - 17, 30.09.2017

Öz

Kaynakça

  • Linn, R.L., Miller, M.D., (2005). Measurement and Assessment in teaching, New Jersey.
  • Miller, G.E. (1990). The assessment of clinical skills / competence / performance. Academic Medicine, 65: 63-67.
  • Hauer, E.K., Mazotti, L.O., Hemmer, A.P., Tong, L. (2011) Faculty verbal evaluations reveal strategies used to promote medical student performance. Medical Education, 16:6354.
  • Rolfe, I.E., Sanson-Fisher, R.W. (2002). Translating learning principles into Practice. Medical Education, 36:345-352.
  • Epstein, R.M., Hundert, E.M. (2002). Defining and assessing professional competence. JAMA, 287:226-235.
  • Kogan, J.R., Holmboe, E.S., Hauer, K.E. (2009). Tools for direct observation and assessment of clinical skills of medical trainees: A systematic review. JAMA, 302:12, 1316-1326.
  • Kang, Y., Bardes, C.L., Gerber, L.M., Storey-Johnson, C. (2009). Pilot of Direct of Clinical Skills (DOCS) in a Medicine Clerkship: Feasibility and Realitionship to Clinical Performance Measures. Medical Education, 14: 1-8.
  • Davis, M.H., Karunathilake, I. (2005). The Place of Oral Examination in today's assessment systems. Medical Teacher, 27(4): 292-297.
  • Hays, R., (2008). Assessment in Medical Education: Roles for clinical teachers. The Clinical Teacher, 5: 23-27.
  • Turnbull, J., Barneveld, C. (2002). Assessment of clinical performance: in-training evaluation. In: Norman, G.R., Vleuten, C.P.M., Newble, D.I. International Handbook of Research in Medical Education, 793-810.
  • Van Der Vleuten, C.P.M. (1996). The assessment of Professional competence: developments, research and practical implications. Advances in Health Sciences Education, 1: 41-67.
  • Van Der Vleuten, C.P.M., Scherpbier, A.J.J.A., Dolmans, D.H.J.M., Schuwirth, L.W.T., Verwijnen, G.M., Wolfhagen, H.A.P. (2000). Clerkship assessment assessed. Medical Teacher, 22(6): 592-600.
  • Van Der Vleuten C.P.M., Schuwirth, L.W.T. (2005). Assessing Professional competence: from methods to programmes. Medical Education, 39: 309-317.
  • Norcini, J.J., (1995). The Mini-CEX (Clinical Evaluation Exercise): A Preliminary Investigation. Annals of Internal Medicine, 123:10, 795-799.
  • Kogan, J.R., Hauer, K.E. (2006). Brief report: Use of the mini-clinical evaluation exercise in internal medicine core clerkships. Journal of General Internal Medicine, 21: 501-502.
  • American Board of Internal Medicine, The Mini-CEX A Quality Tool In Evaluation. 2001-2002.
  • Norcini, J.J., et al., (2003). The Mini-CEX: A Method for Assessing Clinical Skills. Annals of Internal Medicine, 138:476-481.
  • Alves de Lima, A., Barrero, C., Baratta, S., Castillo Costa, Y., Bortman, G., Arabajales, J., et al. (2007). Validity, realiability, feasibility and satisfaction of the Mini-Clinical Evaluation Exercise (Mini-CEX) for cardiology residency training. Medical Teacher, 29:785-790.
  • Weller, J.M., Jolly, B., Misur, M.P., Merry, A.F., Jones, A., Crossley, J.G.M., (2009). Mini-clinical evaluation exercise in anesthesia training. British Journal of Anaesthesia, 102:633-641.
  • Sidhu, R.S., Hatala, R., Barron, S., Broudo, M., Pachev, G., Page, G. (2009). Realibility and acceptance of the mini-clinical evaluation exercise as performance assessment of practicing physicians. Academic Medicine, 84:113-115.
  • Golnik, K.C., Goldenhar, L.M., Gittinger, J.W., Lustbader, J.M. (2004). The ophthalmic Clinical Evaluation Exercise (OCEX). Ophthalmology, 111:1271-1274.
  • Lin Chaou-Shune, Te-Fa Chiu, Yen David, H.T., Chee-Fah Chong. (2012). Mini-Clinical Evaluation Exercise and Feedback on Postgraduate Trainess in the Emergency Department: A Qualitative Content Analysis. Journal of Acute Medicine, 2:1-7.
  • Kogan, J.R., Bellini, L.M., Shea, J.A. (2002). Implementation of the Mini-CEX to Evaluate Medical Students' Clinical Skills. Academic Medicine, 77:11:1156-1157.
  • Hill, F., Kendall, K., (2007). Adopting and adapting the mini-CEX as an undergraduate assessment and learning tool. The Clinical Teacher, 4:244-248.
  • Hill, F., et al., (2009). Implementing the undergraduate mini-CEX: a tailored approach at Southampton University. Medical Education, 43:326-334.
  • Tengiz, F.İ., Şahin, H. (2014). Klinikte Yeni bir Ölçme Yöntemi: Mini Klinik Değerlendirme. Tıp Eğitimi Dünyası, 39:13-18.
  • De Poy, E., Gitlin, L.N. (2004). Introduction to Research Understanding and Applying Multiple Strategies. USA: Elsevier Press.
  • Büyüköztürk, Ş., Çakmak, E.K., Akgün, Ö.E., Karadeniz, Ş., Demirel, F. (2008). Bilimsel Araştırma Yöntemleri. Ankara: Pegem Akademi.
  • Kim, S., Willetr, L.R., Noveck, H. Patel, M.S., Walker, J.A., Terregino, C.A. (2016). Implementation of a Mini-CEX Requirement Across All Third-Year Clerkships. Teaching and Learning in Medicine. 28(4):424-431.
  • Eggleton, K., Goodyear-Smith, F., Paton, L., Falloon, K., Wong, C., Lack, L., Kennelly, J., Fishman, T., Moyes, S.A. (2016). Reliability of Mini-CEX Assessment of Medical Students in General Practice Clinical Attachments. Family Medicine. 48(8):624-30.
  • Kogan, J.R., Bellini, L.M., Shea, J.A. (2003). Feasibility, reliability, and validity of the mini-clinical evaluation exercise (mCEX) in a medicine core clerkship. Academic Medicine, 78:33–35.
  • Wilkinson, J.R., Crossley, J.G.M., Wragg, A., Mills, P., Cowan, G, Wade, W. (2008). Implementing workplace-based assessment across the medical specialities in the United Kingdom. Medical Education. 42: 364-373.
  • Hauer, KE. (2000). Enhancing feedback to students using the mini-CEX. Academic Medicine. 75:542.
  • Torre, D.M., Simpson, D.E., Elnicki, D.M., Sebastian, J.L., Holmboe, E.S. (2007). Feasibility, reliability and user satisfaction with a A-based mini-CEX to evaluate the clinical skills of third-year medical students. Teaching and Learning in Medicine, 19, 271–277.
  • Ney, E.M., Shea, J.A., Kogan, J.R. (2009). Predictive Validity of the mini-Clinical Evaluation Exercise (mCEX): Do Medical Students’mCEX Ratings Correlate with Future Clinical Exam Performance? Academic Medicine. 84(10):17-20.
  • Durning, S.J., Cation, L.J., Markert, R.J., & Pangaro, L.N. (2002). Assessing the reliability and validity of the mini-clinical evaluation exercise for internal medicine residency training. Academic Medicine, 77: 900–904.
  • Norcini, J.J., Blank, L.L., Arnold, G.K., Kimball, H.R. (1997). Examiner differences in the mini-CEX. Adv Health Sci Educ Theory Pract. 2:27–33.
  • Nair, BR, Alexander, HG, Mcgrath, BP, Parvathy, MS, Kilsby, EC, Wenzel, J, Frank, IB, Pachev, GS, Page, GG. (2008). The mini clinical evaluation exercise (mini-CEX) for assessing clinical performance of international medical graduates. Medical Journal of Australia. 189(3):159–161.
  • Holmboe, ES., Huot, S., Chung, J., Norcini, J., Hawkins, RE. (2003). Construct validity of the miniclinical evaluation exercise (miniCEX). Academic Medicine.78:826–830.
  • Pernar, L.I.M., Peyre, S.E., Warren, L.E.G., Gu, X., Lipsitz, S., Alexander, E.K., Ashley, S.W., Breen, E.M. (2011). Mini-clinical evaluation exercise as a student assesment tool in a surgery clerkship: Lessons learned from a 5-year experience. Surgery 150 (2):272-277.
  • Hatala, R., Ainslie, M., Kassen, B. O., Mackie, I., Roberts, J. M. (2006). Assessing the mini-clinical evaluation exercise in comparison to a national specialty examination. Medical Education. 40:950–956.
  • Malhotra S, Hatala R, Courneya CA. (2008). Internal medicine residents’ perceptions of the Mini-Clinical Evaluation Exercise. Medical Teacher. 30:414-419.
  • Holmboe, ES. (2004). Faculty and the Observation of Trainees’ Clinical Skills: Problems and Opportunities. Academic Medicine. 79:16-22.
  • Alves de Lima A, Henquin R, Thierer J, Paulin J, Lamari S, Belcastro F, Van der Vleuten CPM. (2005). A qualitative study of the impact on learning of the mini clinical evaluation exercise in postgraduate training. Medical Teacher 27:46–52.
  • Brazil, V. Ratcliffe, L. Zhang, J. Davin, L. (2012). Mini-CEX as a workplace-based assessment tool for interns in an emergency department – Does cost outweigh value? Medical Teacher. 34;12: 1017-1023.
  • Norcini, J.J. (2010). The Power of Feedback. Medical Education. 44:16-17.
  • Holmboe, E.S., Yepes, M., Williams, F., Huot, S. (2004). Feedback and The Mini Clinical Evaluation Exercise. J Gen Internal Medicine. 19:558-561.
Toplam 47 adet kaynakça vardır.

Ayrıntılar

Bölüm Orjinal Araştırma
Yazarlar

Funda İfakat Tengiz

Hatice Şahin

Yayımlanma Tarihi 30 Eylül 2017
Gönderilme Tarihi 7 Mart 2017
Yayımlandığı Sayı Yıl 2017 Cilt: 16 Sayı: 49

Kaynak Göster

Vancouver Tengiz Fİ, Şahin H. MİNİ KLİNİK DEĞERLENDİRME (MINI-CEX) YÖNTEMİNİN PSİKOMETRİK ÖZELLİKLERİNİN VE KULLANIŞLILIĞININ DEĞERLENDİRİLMESİ “EGE ÜNİVERSİTESİ TIP FAKÜLTESİ ÖRNEĞİ”. TED. 2017;16(49):5-17.