Mini-Clinical Evaluation Exercise in the Era of Milestones and Entrustable Professional Activities in Obstetrics and Gynaecology: Resume or Reform?

Abstract Objective The Accreditation Council for Graduate Medical Education (ACGME) milestones and the core Entrustable Professional Activities (EPAs) provide guiding frameworks and requirements for assessing residents' progress. The Mini-Clinical Evaluation Exercise (Mini-CEX) is a formative assessment tool used to provide direct observation after an ambulatory or clinical encounter. This study aimed to investigate the feasibility and reliability of the Mini-CEX in the authors' obstetrics and gynecology (OB/GYN) residency program and its ability to measure residents' progress and competencies in the frameworks of ACGME milestones and EPAs. Methods OB/GYN residents' 5-academic-year Mini-CEX performance was analyzed retrospectively to measure reliability and feasibility. Additionally, realistic evaluation was conducted to assess the usefulness of Mini-CEX in the frameworks of ACGME milestones and EPAs. Results A total of 395 Mini-CEX evaluations for 49 OB/GYN residents were analyzed. Mini-CEX evaluation data significantly discriminated among residents' training levels (P Conclusion The Mini-CEX demonstrated potential for measuring residents' clinical competencies in their ACGME milestones. Faculty time commitment was the main challenge. Reform is necessary for the current feedback structure in Mini-CEX, faculty development, and operational guidelines that help residency programs match residents' clinical competency ratings with ACGME milestones and EPAs.