gms | German Medical Science

Introduction: Mini-CEX (mini clinical evaluation exercise) and DOPS (direct observation of procedural skills) are two common forms of workplace-based assessment intended to shape and support residents learning [1]. In practice however, experiences with Mini-CEX and DOPS are heterogeneous. Whereas some highly value feedback and find these tools helpful for learning, others perceive Mini-CEX and DOPS as tick-box exercise, as obligation, and as useless waste of time. These differences in user perceptions might arise from socio-cultural aspects. From the socio-cultural perspective, residents, their supervisors and the context, like e.g. learning and assessment culture, cannot be viewed separately, but are considered as closely interdependent [2].

Objectives: To better understand socio-cultural influences on Mini-CEX and DOPS we asked the following research questions:

1.

Which socio-cultural aspects are barriers regarding residents' learning with Mini-CEX and DOPS?

2.

Which socio-cultural aspects foster residents' learning with Mini-CEX and DOPS?

Methods: We perform a constructivist Grounded Theory study [3]. So far, we conducted four focus groups in two different departments at a Swiss university hospital and extracted preliminary results from our notes taken during the focus groups.

Preliminary results: Residents and supervisors perceived the lack of priority on residency training as a barrier. That and the enormous clinical time constraints seem to inhibit residents to ask for Mini-CEX and DOPS. Another barrier was the low credibility of Mini-CEX and DOPS which was due to missing standards of good performance, supervisors that were not well trained in using the tools, the use of Mini-CEX and DOPS as snapshot tools only, and missing consequences.

As facilitating aspects residents and supervisors suggested to better integrate these tools into the training program, to provide defined standards of good performance, as well as feedback training for supervisors.

Conclusion: By better understanding socio-cultural influences by the end of the study, we might be able to provide recommendations how to improve residents' learning with Mini-CEX and DOPS.