Mini-clinical evaluation exercise and feedback on postgraduate trainees in the emergency department: A qualitative content analysis

Background/IntroductionMini-clinical evaluation exercises (mini-CEXs) have been successfully adapted as a formative and summative assessment tool for various different postgraduate medical programs. However, only a few studies have evaluated its use in the setting of an emergency department (ED).Purpose(s)/Aim(s)The purpose of this study was to examine the quality of feedback given by preceptors to postgraduate Year 1 (PGY-1) residents during mini-CEXs in EDs.MethodsThis prospective observational study involved EDs at 20 teaching hospitals and comprised 893 mini-CEX encounters involving 230 PGY-1 trainees and 242 preceptors. All feedback forms, which contained three sections, namely “Positive Feedback,” “Negative Feedback,” and “Action Plan,” were assessed using qualitative content analysis techniques.ResultsA total of 734 mini-CEX sessions (82.2%) contained positive feedback, 507 (63.8%) contained negative feedback, 350 (39.2%) contained action plans, and 131 (14.7%) had no feedback. These written feedback comments could be structured into 1,877 coded items and grouped into seven domains of clinical competence. These were: (1) medical interviewing, (2) physical examination, (3) professionalism, (4) clinical judgment, (5) counseling, (6) organization/efficiency, and (7) clinical procedures.ConclusionDuring feedback from the mini-CEXs in the ED setting, preceptors to the PGY-1 students tend to emphasize clinical judgment and seemed to pay less attention to facilitate the development of reflective skills and communication skills.