The educational impact of Mini-Clinical Evaluation Exercise (Mini-CEX) and Direct Observation of Procedural Skills (DOPS) and its association with implementation: A systematic review and meta-analysis

Lörwald, Andrea C.; Lahner, Felicitas-Maria; Nouns, Zineb M.; Berendonk, Christoph; Norcini, John; Greif, Robert; Huwendiek, Sören (2018). The educational impact of Mini-Clinical Evaluation Exercise (Mini-CEX) and Direct Observation of Procedural Skills (DOPS) and its association with implementation: A systematic review and meta-analysis. PLoS ONE, 13(6), e0198009. Public Library of Science 10.1371/journal.pone.0198009

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INTRODUCTION Mini Clinical Evaluation Exercise (Mini-CEX) and Direct Observation of Procedural Skills (DOPS) are used as formative assessments worldwide. Since an up-to-date comprehensive synthesis of the educational impact of Mini-CEX and DOPS is lacking, we performed a systematic review. Moreover, as the educational impact might be influenced by characteristics of the setting in which Mini-CEX and DOPS take place or their implementation status, we additionally investigated these potential influences. METHODS We searched Scopus, Web of Science, and Ovid, including All Ovid Journals, Embase, ERIC, Ovid MEDLINE(R), and PsycINFO, for original research articles investigating the educational impact of Mini-CEX and DOPS on undergraduate and postgraduate trainees from all health professions, published in English or German from 1995 to 2016. Educational impact was operationalized and classified using Barr's adaptation of Kirkpatrick's four-level model. Where applicable, outcomes were pooled in meta-analyses, separately for Mini-CEX and DOPS. To examine potential influences, we used Fisher's exact test for count data. RESULTS We identified 26 articles demonstrating heterogeneous effects of Mini-CEX and DOPS on learners' reactions (Kirkpatrick Level 1) and positive effects of Mini-CEX and DOPS on trainees' performance (Kirkpatrick Level 2b; Mini-CEX: standardized mean difference (SMD) = 0.26, p = 0.014; DOPS: SMD = 3.33, p<0.001). No studies were found on higher Kirkpatrick levels. Regarding potential influences, we found two implementation characteristics, "quality" and "participant responsiveness", to be associated with the educational impact. CONCLUSIONS Despite the limited evidence, the meta-analyses demonstrated positive effects of Mini-CEX and DOPS on trainee performance. Additionally, we revealed implementation characteristics to be associated with the educational impact. Hence, we assume that considering implementation characteristics could increase the educational impact of Mini-CEX and DOPS.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Medical Education > Institute for Medical Education > Assessment and Evaluation Unit (AAE)
04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic and Policlinic for Anaesthesiology and Pain Therapy
04 Faculty of Medicine > Medical Education > Institute for Medical Education

UniBE Contributor:

Lörwald, Andrea Carolin; Lahner, Felicitas-Maria; Berendonk, Christoph; Greif, Robert and Huwendiek, Sören

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1932-6203

Publisher:

Public Library of Science

Language:

English

Submitter:

Daniel Bauer

Date Deposited:

01 Nov 2018 14:57

Last Modified:

04 Nov 2018 02:32

Publisher DOI:

10.1371/journal.pone.0198009

PubMed ID:

29864130

BORIS DOI:

10.7892/boris.120814

URI:

https://boris.unibe.ch/id/eprint/120814

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