Objective: To determine if the clinical evaluation exercise (CEX) format is reliable, applicable and useful for evaluating clinical competency in the postgraduate chiropractic program as formative feedback.
Methods: Twelve mini-CEX clinical encounters were evaluated by 2 assessors per clinical encounter (7 assessors per session) in 23 chiropractic residents over a 12-month period. Two different rating scales (9 point and 5 point) were used, and the 2 assessors completed the forms independently. Individual competencies assessed consisted of history taking, physical examination, organization/efficiency, clinical judgment, professionalism/communication, counseling, and overall clinical performance. Interassessor reliability was calculated using κ and intraclass correlation coefficient statistics. Cronbach α assessed internal consistency of the mini-CEX. Spearman correlation coefficient evaluated correlation between the various competencies. The Mann-Whitney U test evaluated differences between the assessors' median numerical scores.
Results: The κ value for the 9-point rating scale was 0.31 (fair) and for the 5-point scale was 0.42 (moderate) with statistically significant intraclass correlation values (p < .05) for 4 of the 6 competencies. High correlation coefficients (p = .0001) were found when comparing the various competencies at each clinical encounter. There were no significant differences between the 2 assessors per clinical encounter for the scores awarded to the residents.
Conclusions: The mini-CEX is a reliable and useful tool to provide valuable formative feedback to postgraduate chiropractic residents. The 5-point grading scale was more user-friendly with better reliability.
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