The document discusses various methods for assessing clinical skills in medical education, including mini-clinical evaluation exercises (MiniCEX), direct observation of procedural skills (DOPS), multi-source feedback (MSF), logbooks, portfolios, simulations, record reviews, and patient surveys. It emphasizes that the assessment method should be tailored based on the domain and level being tested, available resources, and whether the goal is formative or summative. Objective methods are preferred over traditional methods to reduce bias. A variety of approaches can provide insights into different aspects of clinical competency.

1. Dr Swati Deshpande
MEU Member
Asst Prof General Surgery
MAMS
One minute preceptor (OMP)

2. Set induction
Your Post graduate trainee brings a patient to
you in OPD. How will you utilise this occasion
to teach him/her?

3. Specific learning objectives
At the end of this session the participants should be
able to
 Describe one minute preceptor technique
 Mention stages in one minute preceptor technique
 Describe SNAPPS method
 Compare traditional method vs OMP vs SNAPPS

4. Introduction
 Interactive method
 Diagnosis driven
 Discussion more than teaching
 Misnomer
 Efficient time syllabus ratio
 Undertaken in clinical settings

9. SNAPPS model

11. Comparison between traditional
methods and OMP
No Traditional method OMP
1 Patient oriented,
teacher centred
Gets a commitment, assess
previous knowledge
2 Low level questions Probe for evidence- knowledge
gap
3 Mini -lectures Teach general rules
4 Little or no feedback Reinforce what was done
correctly
5 No scope for mistake
correction
Correct mistakes

12. Assessment of clinical skills
 Long case
 OSCE/OSPE
 MiniCEX
 DOPS
 MSF
 Patient management problems,
 portfolios,
 log book,
 Simulators
Shows how
Does of Miller’s pyramid

13. MiniCEX- mini clinical evaluation
exercise
 American board of Internal Medicine
 Short tutor observations(15-20 min) of routine
interactions that supervising clinicians and trainees
have on a daily basis
 opportunity for feedback from the evaluator and is
 mostly used for formative assessment

14.  Performance is recorded on a 4 point scale where
1 = unacceptable, 2 = below expectation, 3 = met
expectations, and 4 = exceeded expectations.
 Assess six core competencies of residents
A) Medical interviewing skills
B) Physical examination skills
C) Professionalism/ humanistic qualities
D) Clinical judgement,
E) Counselling skills
F) Organisation and efficiency

16. Direct observation of procedural
skills(DOPS) in clinical subjects
Assesses
 Knowledge about the
procedure
 Informed consent
 Pre procedure
preparation
 Analgesia
 Technical ability
 Post procedure
management
 Counselling and
 Communication

18. Mini-peer assessment tool (mPAT)
 Eight assessors are nominated by the
trainee from among his/her supervisors
or peers, including nurses and other
health professionals(3)
 questionnaire concerning the technical
and interpersonal skills of the trainee.
 an agreement about the strengths and
weaknesses of the trainee and a plan for
improvement
 formative assessment

19. Clinical work sampling
 Collection of data at the same time it is performed by
multiple observers and occasions
 Removes rating bias and system bias
 Checklists
 5-7 scale

20. 360 degree evaluation/
multisource feedback(MSF)
 Insight into trainee’s work habits, team spirit,
interpersonal sensitivity
 Multiple evaluators, who may include superiors,
peers, students, administrative staff, patients and
families, rate trainee performance in addition to the
trainee doing a self-assessment
 Includes narrative comments as well as statistical
data

22. Logbook
 Students keep a record of the patients seen or
procedures performed either in a book or in a
computer (e-logbook).
 It documents the range of patient care and learning
experience of students.
 Logbook is very useful in focusing students on
important objectives that must be fulfilled within a
specified period of time (Blake, 2001).

23. Portfolio
 Collection of one’s
professional and
personal goals,
achievements, and
methods of achieving
these goals.
 trainees’ development
and technical capacity.

25. Portfolio includes
case reports;
record of practical procedures undertaken;
videotapes of consultations; project reports;
samples of performance evaluations;
learning plans, and
written reflection about the evidence provided.
 Valid with low reliability.

27. Key Feature Test
 Clinical scenario-based paper and pencil test.
 Description of the problem is followed by a limited
number of questions that focus on critical, challenging
actions or decisions.
 It has higher content validity with proper blueprinting.

28. Script Concordance test (SCT)
 designed to test clinical reasoning in uncertain
short case scenarios followed by related questions in
three parts:
 the first part ("if you were thinking of") contains a
relevant diagnostic or management option;
 the second part ("and then you were to find") presents
a new clinical finding,
 and the third part ("this option would captures
examinees' decisions ") as to what effect the new
finding has on the status of the option - is a five point
Likert scale

29. Simulators
 Aeronautical industry and military services
 first flight simulator being developed in 1929
 A simulator is defined as a device that enables the
operator to reproduce or represent under test
conditions phenomena likely to occur in actual
performance

30.  Simulation has been defined as a situation in which a
particular set of conditions is created artificially in
order to study or experience something that is
possible in real life;
 a generic term that refers to the artificial
representation of a real world process to achieve
educational goals via experimental learning.

31. Simulators

32. Procedure, operative or case logs
 Patient case logs involve recording of some number
of consecutive cases in a designated time frame.
 determining the scope of patient-care experience.

33. Record review
 evidence about clinical decision-making,
 follow through in patient management
 and appropriate use of clinical facilities and
 A sample of 8–10 patient records is sufficient for a
reliable assessment of care for a diagnosis or
procedure.

34. Patient surveys
 to assess satisfaction with the hospital or clinic visits
typically include questions about the physician’s care.
- time spent with the patient,
- overall quality of care,
- competence of the physician,
- courtesy, interest and empathy,
- listening skills,

35. - Explanation about the problem,
- Results of diagnostic tests,
- treatment planned
- side effects of drugs
- formative assessments and performance
improvement.
 The American Board of Internal Medicine reports that
20–40 patient responses were needed to obtain a
reliability of 0.70–0.82 on individual resident ratings.

36. Summary
 Assessment of clinical skills can be done in various
ways
 Assessment should be tailored with the
- domain to be tested,
- level of the student to be tested,
- resources available,
- whether formative or summative assessment,
- level of Miller’s pyramid to be tested
 Objective methods preferred to traditional methods to
remove subject bias and rating bias.

37. References
1) Syed Amin Tabish. Int J Health Sci(Qassim).
Assessment Methods In Medical Education.2008
Jul; 2(2): 3–7.
2) Nadia M Al-Wardy. Assessment Methods In
Undergraduate Medical Education. Sultan Qaboos
Univ Med J. 2010 Aug; 10(2): 203–209.
3) Rita Sood, Tejinder Singh. Assessment In Medical
Education: Evolving Perspectives And Contemporary
Trends The National Medical Journal Of India Vol. 25,
No. 6, 2012.