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Syst Rev. 2017 Jul 18;6(1):146. doi: 10.1186/s13643-017-0539-y.

The utility of mini-Clinical Evaluation Exercise (mini-CEX) in undergraduate and postgraduate medical education: protocol for a systematic review.

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Department of Medical Education, Health Professions Education Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Department of Medical Education, Department of Emergency Medicine, Tehran University of Medical Sciences, 57, Hojjatdoust St, Keshavarz Blvd, Tehran, Iran.
Education Development Center, Department of Medical Education, Tehran University of Medical Sciences, Tehran, Iran.
Department of Clinical Science and Education at SOS Hospital, Karolina Institute, Stockholm, Sweden.
Department of Medical Education, Tehran University of Medical Sciences, Tehran, Iran.
Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Foundation for Advancement of International Medical Education and Research (FAIMER), Philadelphia, PA, USA.



One of the most frequently used assessment tools that measure the trainees' performance in workplace is the mini-Clinical Evaluation Exercise (mini-CEX), in which an expert observes and rates the actual performance of trainees. Several primary studies have evaluated the effectiveness of mini-CEX by assessing its educational and psychometric properties. The objective of this BEME review is to explore, analyze, and synthesize the evidence considering the utility of the mini-CEX for assessing undergraduate and postgraduate medical trainees.


Studies reporting on mini-CEX performed in undergraduate and postgraduate medical education and providing some empirical data for mini-CEX in relation to one or more of the validity, reliability, educational impact, acceptability, and cost of mini-CEX will be included in the review. No restrictions on study design or publication date or language will be handled. To ensure comprehensiveness of our search, we will use different approaches and methods. In addition to electronic search in bibliographic databases, we will conduct forward and backward searching. We will also contact leading authors in the field of mini-CEX and will search for the gray literature. Data extractions will be done independently by two coders based on a form. If there is any discordance, a third author will resolve it. The quality assessment will be also done independently by two team members, based on critical appraisal checklists. In attempting to answer our original research questions, we will use meta-analysis or meta-synthesis.


The findings of this study can be transferred to the medical education stakeholders such as administrators of medical schools, residency program directors, and faculty members. We also hope that publication of this review will encourage stakeholders who have already adopted the mini-CEX to evaluate and report its different characteristics. Lastly, we expect that we can identify gap of knowledge in this field and suggest areas for future research.


Systematic review; Workplace-based assessment; mini-CEX

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