New Year 5 Community Assessments: Guidance for Students
We have introduced new assessments in a pilot format for the academic year 2007-08. They are designed to prepare you for the assessments you will experience in the foundation years. We have modified them slightly in order to make them suitable for students and to maximise the educational benefit.
Mini-CEX
What is the purpose of Mini-CEX?
In OSCEs, you are observed consulting with simulated patients. In mini-CEX, you to are observed consulting with a real patient with a real clinical problem. Assessment is followed by immediate feedback.
How will it work in practice?
Tutors should choose a suitable patient. Because of the unpredictable nature of medicine in the community, the first patient chosen may turn out to be unsuitable for a variety of reasons. Do not worry; there will be other opportunities.
The patient may be presenting with a new problem, or may have come for review of an ongoing problem. Alternatively, your tutor may ask you to explain details about an illness, a test result etc.
During the consultation, please behave as you would if the tutor was not observing you. The tutor will assess your performance in 6 categories:
- history taking
- physical examination skills
- professionalism
- clinical judgement
- communication skills
- organisation and efficiency
After the consultation, the tutor will give you immediate feedback. You will be able to take a copy of the report to keep in your portfolio.
Case-based Discussion (CbD)
What is the purpose of CbD?
We are aware that you discuss patients all the time. However, the CbD is designed to ensure you can discuss patients in a logical, systematic and thorough manner. Assessment is followed by immediate feedback.
How will it work in practice?
Tutors should choose suitable patients in negotiation with your learning needs. These may well be patients who you see regularly throughout the attachment. They will often have quite complex problems. Please discuss the choice of patient with your tutor.
As well as interviewing the patient (and carers if appropriate), you should have access to their notes to study results of investigations etc (with the patient’s consent). You are expected to read widely around the aspects of the patient’s problems, considering the evidence basis for the assessment and management of the patient.
You must write up your own clinical notes from your interview(s) and submit them to the tutor in advance of the meeting. Do not copy these from the clinical record or from hospital letters: this is plagiarism and will mean you will be referred to Progress Committee.
The discussion should normally last about 15 – 20 minutes. This is not meant to be an unpleasant interrogation. Instead, it is a discussion between two professionals. However, the tutor does need to probe and ask searching questions in order to allow you to demonstrate your knowledge and competence.
The tutor is assessing your performance in 6 areas:
- medical record keeping
- clinical assessment
- investigations
- treatment
- follow-up and future planning
- professionalism and clinical judgement
After the discussion, the tutor will give you immediate feedback. You will be able to take a copy of the report to keep in your portfolio.
Passing the Assessments
You do not need to be perfect in all categories. We are aware that there may be teething problems as tutors and students adjust to a new system. Allowances will also be made for variations in the complexities of cases encountered. It is more important that you make a serious attempt to do well in both assessments, rather than worry about your overall ‘score’. However, if the tutor feels your overall performance is well below the level expected, you will be asked to repeat the assessments. If you fail to complete the assessments, or you display behaviour that calls your professionalism into question, you will be referred to your Hospital Dean or Progress Committee.
Remember that it is your responsibility to ensure you complete both assessments satisfactorily before the end of your attachment. Failure to do so could result in you failing to graduate.
Thank you for helping to pilot a new form of assessment. We hope it will benefit you when you enter F1. We will be asking for your views later in the year.
Chris Harrison
Lead for Year 5 Community Assesments
New Year 5 Community Assessments: Guidance for Students