Journal Article

Mini-clinical evaluation exercise in anaesthesia training

J. M. Weller, B. Jolly, M. P. Misur, A. F. Merry, A. Jones, J. G. M Crossley, K. Pedersen and K. Smith

in BJA: British Journal of Anaesthesia

Published on behalf of the British Journal of Anaesthesia

Volume 102, issue 5, pages 633-641
Published in print May 2009 | ISSN: 0007-0912
Published online March 2009 | e-ISSN: 1471-6771 | DOI:
Mini-clinical evaluation exercise in anaesthesia training

Show Summary Details



The Mini-Clinical Evaluation Exercise (Mini-CEX) is a workplace-based assessment tool of potential value in anaesthesia to assess and improve clinical performance. Its reliability and positive educational impact have been reported in other specialities, but not, to date, in anaesthesia. In this study, we evaluated the psychometric characteristics, logistics of application, and impact on the quality of supervision of the Mini-CEX in anaesthesia training.


A Mini-CEX encounter consisted of a single specialist anaesthetist observing a trainee over a defined period of time, completing an online Mini-CEX form with the trainee, and providing written and verbal feedback. We sought trainee and supervisor perspectives on its value and ease of use and used Generalizability Theory to estimate reliability.


We collected 331 assessments from 61 trainees and 58 assessors. Survey responses strongly supported the positive effect of the Mini-CEX on feedback, its relative feasibility, and acceptance as a potential assessment tool. In this cohort, we found variable assessor stringency and low trainee variation. However, a feasible sample of cases and assessors would produce sufficiently precise scores to decide that performance was satisfactory for each trainee with 95% confidence. To generate scores that could discriminate sufficiently between trainees to allow ranking, a much larger sample of cases would be needed.


The Mini-CEX in anaesthesia has strengths and weaknesses. Strengths include: its perceived very positive educational impact and its relative feasibility. Variable assessor stringency means that large numbers of assessors are required to produce reliable scores.

Keywords: education, junior staff

Journal Article.  4182 words.  Illustrated.

Subjects: Anaesthetics

Full text: subscription required

How to subscribe Recommend to my Librarian

Users without a subscription are not able to see the full content. Please, subscribe or login to access all content. subscribe or login to access all content.