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NCT Number: NCT07663760

Impact of a Simulated Mini-CEX on Clinical Performance During a Real-World Mini-CEX

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.

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

About this study

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.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

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.

Treatment and study plan

Behavioral

Other

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.

Other names: Simulated Mini-CEX, Mini-CEX-based educational intervention

Primary outcomes

  1. students' overall performance

    Time frame: 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 outcomes

  1. Scores for each domain

    Time frame: 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.

  2. Inter-rater reproducibility of Mini-CEX

    Time frame: 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

  3. Individual performance gain

    Time frame: 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.

  4. Learner and faculty satisfaction

    Time frame: 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.

  5. The time required to complete the consultation

    Time frame: at the end of each Mini-Cex, Through study completion, up to 4 weeks

    The time required to complete the consultation (measured in minutes)

Study contacts

Contact information is provided by the study sponsor or research team.

Ben Haj youssef, assistant

CONTACT

[email protected]

96874336 ext. 00216

Mhamed Sami Mebazaa, professor

CONTACT

[email protected]

22252589 ext. 00216

Sponsors and collaborators

Lead sponsor

Mongi Slim Hospital

Other

Registry information

Official study title

Impact of a Simulated Mini-CEX on Clinical Performance During a Real-World Mini-CEX: A Multicenter Study in Anesthesiology and Intensive Care Medicine

Important dates

Study start
2026
Primary completion
2026
Study completion
2026
First posted
Jun 23, 2026
Registry last updated
Jun 23, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.