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Clinical performance assessment types
A clinical assessment is an evaluation of a patient's physical condition and prognosis based on information gathered from physical and laboratory examinations and the patient's medical history.
Clinical evaluation exercise (CEX)
A clinical evaluation exercise is an exam format that involves a relatively long, pre-planned single patient encounter in a clinical setting. A clinician observes the student taking a history and performing a physical examination. The student presents the findings and decides on the diagnosis and the treatment plan. Additionally, a written patient report is produced. The examiner gives feedback.
Directly Observed Procedural Skills (DOPS)
Directly Observed Procedural Skills (DOPS), also referred to as Direct Observation of Procedural Skills or clinical skill competency, is designed specifically to assess practical skills in a workplace setting. A student is observed and scored by an assessor while performing a routine practical procedure during normal clinical work. The assessor uses a standard DOPS form to score the technique. For any particular skill, the student has to pass one or a number of assessments to be signed off as competent at that skill.
A long case, also referred to as a client interview, client assessment or client consultation, sees a student spend a period of time with a client, gather history, perform a clinical examination and then report the findings to the examiner. In some instances, the examiner is present throughout and will ask the student to ‘think aloud’ during the client encounter.
Mini-clinical evaluation exercise (mini-CEX)
The mini-CEX is designed to assess students’ clinical competencies and facilitate feedback to drive learning. It involves an assessor/supervisor observing the student interact with a patient, in an unrehearsed clinical encounter. The assessor’s evaluation is typically recorded on a structured checklist, which enables immediate provision of feedback to the student. The mini-CEX is used for both formative and summative assessment purposes.
Multi-station assessment task (MSAT)
A Multi-Station Assessment Task (MSAT) requires students to demonstrate core clinical competencies to examiners across a series of tasks.
Objective structured clinical examination (OSCE)
An Objective Structured Clinical Examination involves students moving around multiple mini-stations in sequence, completing a variety of tasks that test a range of skills. The student reads the scenario, then enters the station and undertakes the task. The task is of typically short duration.
Practical assessment (the ‘Spot’ test)
The practical assessment, or ‘Spot’ test, involves students moving around a series of stations consisting of, for example, a specimen, a labelled dissection or radiograph. The response to the station activity may be a one word answer or require some level of deduction or diagnostic skill.