Mini-Clinical Evaluation Ecercise (CEX) - Medical Students
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Mini-Clinical Evaluation Exercise (CEX) MEDICAL STUDENTS Evaluator: _______________________________ Date: __________________________________ Student: ______________________________ Yr 4 Yr 5 Patient Problem/Dx: ____________________________________________________________________ Setting: Ambulatory In-patient ED Other Patient: Age: ________ Sex: _______ New Follow-up Complexity: Low Moderate High Focus: Data Gathering Physical Examination Diagnosis Therapy 1. Medical Interviewing Skills ( Not observed) 1 2 3 4 5 6 7 8 9 UNSATISFACTORY SATISFACTORY SUPERIOR _________________________________________________________________________________________________________ ______________ 2. Physical Examination Sills ( Not observed) 1 2 3 4 5 6 7 8 9 UNSATISFACTORY SATISFACTORY SUPERIOR _________________________________________________________________________________________________________ _______________ 3. Humanistic Qualities/Professionalism 1 2 3 4 5 6 7 8 9 UNSATISFACTORY SATISFACTORY SUPERIOR _________________________________________________________________________________________________________ _______________ 4. Clinical Judgment ( Not observed) 1 2 3 4 5 6 7 8 9 UNSATISFACTORY SATISFACTORY SUPERIOR _________________________________________________________________________________________________________ _______________ 5. Counseling Skills ( Not observed) 1 2 3 4 5 6 7 8 9 UNSATISFACTORY SATISFACTORY SUPERIOR _________________________________________________________________________________________________________ _______________ 6. Organization/Efficiency ( Not observed)
description
Mini CEX evaluation form
Transcript of Mini-Clinical Evaluation Ecercise (CEX) - Medical Students
Mini-Clinical Evaluation Exercise (CEX)MEDICAL STUDENTS
Evaluator: _______________________________ Date: __________________________________
Student: ______________________________ Yr 4 Yr 5
Patient Problem/Dx: ____________________________________________________________________
Setting: Ambulatory In-patient ED Other
Patient: Age: ________ Sex: _______ New Follow-up
Complexity: Low Moderate High
Focus: Data Gathering Physical Examination Diagnosis Therapy
1. Medical Interviewing Skills ( Not observed)
1 2 3 4 5 6 7 8 9
UNSATISFACTORY SATISFACTORY SUPERIOR _______________________________________________________________________________________________________________________
2. Physical Examination Sills ( Not observed)
1 2 3 4 5 6 7 8 9
UNSATISFACTORY SATISFACTORY SUPERIOR ________________________________________________________________________________________________________________________
3. Humanistic Qualities/Professionalism
1 2 3 4 5 6 7 8 9
UNSATISFACTORY SATISFACTORY SUPERIOR ________________________________________________________________________________________________________________________
4. Clinical Judgment ( Not observed)
1 2 3 4 5 6 7 8 9
UNSATISFACTORY SATISFACTORY SUPERIOR ________________________________________________________________________________________________________________________
5. Counseling Skills ( Not observed)
1 2 3 4 5 6 7 8 9
UNSATISFACTORY SATISFACTORY SUPERIOR ________________________________________________________________________________________________________________________
6. Organization/Efficiency ( Not observed)
1 2 3 4 5 6 7 8 9
UNSATISFACTORY SATISFACTORY SUPERIOR ________________________________________________________________________________________________________________________
7. Overall Clinical Competence ( Not observed)
1 2 3 4 5 6 7 8 9
UNSATISFACTORY SATISFACTORY SUPERIOR ________________________________________________________________________________________________________________________
Mini-CEX Time: Observing _________ Mins Providing Feedback_________ Mins
Evaluator Satisfaction with Mini-CEX
LOW 1 2 3 4 5 6 7 8 9 HIGH
Student Satisfaction with Mini-CEX
LOW 1 2 3 4 5 6 7 8 9 HIGH
Comments: __________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
_______________________________ _______________________________
Student Signature Evaluator Signature
