Effect of Faculty Development on Mini-CEX Score Reliability and Accuracy: A Randomized, Controlled Trial

An intervention for training faculty preceptors on the use of the mini-CEX will improve inter-rater reliability and classification accuracy.

Methods. We will develop a faculty development workshop aimed at improving the inter-rater reliability and accuracy of mini-CEX scores. To evaluate the workshop we will conduct a randomized, controlled trial. Preceptors will be randomly assigned to immediate or delayed workshop. The primary outcome will be inter-rater reliability of mini-CEX scores as preceptors rate videotaped resident-patient encounters before and four weeks after the workshop. We will also evaluate the accuracy of performance classifications. We will also collect mini-CEX ratings of actual resident-patient interactions one year preceding and one year following the workshop, and calculate interrater reliability.

Statistical methods. Inter-rater reliability will be determined using the intraclass correlation coefficient (ICC) and corresponding confidence intervals. ICC will be used to determine chance-corrected agreement (accuracy). Discrimination (differences in mean scores among scripted levels of performance) will also be evaluated as a measure of accuracy.

Scientific basis. Clinical performance assessments constitute a key element of resident education. The effect of rater training on the inter-rater reliability of mini-CEX scores is unknown. This workshop will utilize methods (rater error and field of reference training) shown to be effective in improving rater accuracy in non-medical fields.

Inclusion criteria. All internal medicine residency continuity clinic preceptors are eligible.