Volunteers Medical Students in Anesthesiology-intensive Care
Conditions
Keywords
Competence, Medical education, Anesthesiology, Assessment
Brief summary
Modern medical education is based on competency-based learning and the use of formative assessment tools in real clinical settings, such as the Mini-Clinical Evaluation Exercise (mini-CEX). However, the impact of a prior simulated mini-CEX experience on subsequent performance in real clinical settings remains insufficiently studied, particularly among medical students in anesthesiology-intensive care (DCEM3). This study aimed to assess the effect of a simulated mini-CEX on performance during a real mini-CEX in pre-anesthetic consultation.
Detailed description
We conducted a prospective, multicenter interventional study over 4 weeks in three anesthesiology-intensive care departments in Tunis. Volunteer DCEM3 students were assessed by trained anesthesiology faculty using the mini-CEX tool. The intervention consisted of a structured two-step assessment of pre-anesthetic consultation: a standardized simulation followed by a real clinical encounter. Performance was evaluated using a 7-domain mini-CEX checklist, including direct observation, scoring, and immediate formative feedback. The primary outcome was the overall mini-CEX score. Secondary outcomes included domain-specific scores, inter-rater reliability, individual progression, and participant satisfaction.
Interventions
OTHERBehavioral
Mini-CEX educational assessment during pre-anesthetic consultation: Volunteer fifth-year medical students were assessed by trained anesthesiology faculty using the mini-CEX tool. The intervention consisted of a structured two-step assessment of pre-anesthetic consultation: a standardized simulation followed by a real clinical encounter.
Sponsors
Mongi Slim Hospital
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
OTHER
Masking
NONE
Intervention model description
Volunteer DCEM3 students were assessed by trained anesthesiology faculty using the mini-CEX tool. The intervention consisted of a structured two-step assessment of pre-anesthetic consultation: a standardized simulation followed by a real clinical encounter. Performance was evaluated using a 7-domain mini-CEX checklist, including direct observation, scoring, and immediate formative feedback.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Fifth-year medical students (DCEM3) enrolled at the Faculty of Medicine of Tunis within the acute medicine program. * Students completing their clinical clerkship during the second semester of the 2025-2026 academic year in one of the three participating anesthesiology and intensive care departments. * Students who voluntarily agree to participate and have provided written informed consent.
Exclusion criteria
* Students who do not complete the entire educational curriculum (absence from either of the two assessments). * Students who have already received similar training.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| students' overall performance | Through study completion, up to 4 weeks | measured by the mean score on the Mini-CEX checklist, compared between simulated consultation and real consultation. The overall performance is assessed using the unabbreviated Mini-Clinical Evaluation Exercise (Mini-CEX) checklist. The global score is measured on a 9-point Likert scale, ranging from 1 (insufficient/unsatisfactory performance) to 9 (exceptional/exemplary performance). Higher scores indicate a better clinical performance and greater student autonomy. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Scores for each domain | at the and of each Mini-CEX , Through study completion, up to 4 weeks | Scores for each domain (history taking, physical examination, clinical judgment, communication skills, professionalism, organization and efficiency, and overall clinical performance). Measured by the Mini-Clinical Evaluation Exercise (Mini-CEX) checklist, compared between the simulated consultation (baseline) and the real clinical consultation. The checklist uses a 9-point Likert scale where 1 represents the lowest performance (insufficient) and 9 represents the highest performance (exceptional). Higher scores indicate a better clinical outcome. |
| Inter-rater reproducibility of Mini-CEX | at the end of the simulated Mini-CEx, Through study completion, up to 4 weeks | Inter-rater reproducibility was evaluated using the Intraclass Correlation Coefficient (ICC |
| Individual performance gain | at the end of the internship, Through study completion, up to 4 weeks | Individual performance gain (delta between simulated and real Mini-CEX scores) Calculated as the change score between the real clinical consultation and the simulated consultation (Real score minus Simulated score) using the unabbreviated Mini-Clinical Evaluation Exercise (Mini-CEX). The original Mini-CEX scale ranges from a minimum value of 1 (insufficient performance) to a maximum value of 9 (exceptional performance). The resulting performance gain score ranges from -8 to +8. A higher or positive score indicates a better outcome (improvement/performance gain), a score of 0 indicates no change, and a negative score indicates a decrease in performance. |
| Learner and faculty satisfaction | at the end of internship, Through study completion, up to 4 weeks | Learner and faculty satisfaction, as well as their recommendation for the use of the Mini-CEX throughout the curriculum, assessed using a Likert scale. Assessed via a post-internship questionnaire completed by both students (learners) and professors (faculty) regarding their satisfaction with the Mini-Clinical Evaluation Exercise (Mini-CEX) and their recommendation for its integration throughout the curriculum. Responses are evaluated on a 5-point Likert scale, ranging from a minimum score of 1 (Strongly disagree / Very dissatisfied) to a maximum score of 5 (Strongly agree / Very satisfied). Higher scores indicate a better outcome, representing higher levels of satisfaction and a stronger recommendation for curriculum implementation. |
| The time required to complete the consultation | at the end of each Mini-Cex, Through study completion, up to 4 weeks | The time required to complete the consultation (measured in minutes) |
Contacts
CONTACTMhamed Sami Mebazaa, professor
CONTACTBen Haj youssef, assistant
Outcome results
None listed