1. نام پروردگارت را یاد کن و تنها به او دل ببند.
سوره مزمل

2. PhD student in Medical Education
Journal Club
Atefe Zabihi Zazoly
PhD student in Medical Education
2018 2

3. Factors influencing the educational impact of Mini-
Title:
Factors influencing the educational impact of Mini-
CEX and DOPS: A qualitative synthesis
Med Teach Apr;40(4): 3 97

4. Authors
Andrea C. Lörwalda
Felicitas-Maria Lahnera
Robert Greifb
Christoph Berendonka
John Norcinic
Sören Huwendieka
a Department of Assessment and Evaluation, Institute of Medical Education, University of Bern, Bern, Switzerland
b Anaesthesiology and Pain Medicine, Bern University Hospital, Bern, Switzerland
c Foundation for Avancement of International Medical Education and Research (FAIMER), Philadelphia, PA, USA 4

5. zabihi1823@gmail.com-Autumn 97
Table of Contents
Abstract
Introduction
Objective
Method
Result
Discussion
Conclusion 5 97

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Abstract
There is no existing comprehensive analysis and synthesis of factors influencing the educational impact of Mini-CEX and DOPS.
The authors chose a two-step approach.
(a systematic literature review & a qualitative synthesis)
They offered a model consisting of four themes and nine subthemes as influencing factors. 6 97

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Introduction
Mini-CEX & DOPS:
The two most commonly forms of workplace-based assessment
Effects on the:
Learner’s reaction
Modification of attitudes and perceptions
Acquisition of knowledge and skills
Change in behavior
Change in organizational practice
Benefits to clients or patients 7 97

8. Supervisors' knowledge
Introduction
Many factors might influence the educational impact of Mini-CEX and DOPS.
Feedback
Purpose
Supervisors' interest
Trainees' mindsets
Supervisors' knowledge 8 97

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Objective
To synthesize factors influencing the educational impact of Mini-CEX and DOPS into a model based on a systematic review of the literature. 9 97

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Methods
Systematic literature review and study selection
Qualitative synthesis of influencing factors 10 97

11. Method: Systematic literature review
The electronic databases: Scopus, Web of Science (all databases), and Ovid including All Ovid Journals (Full Text & Abstracts), Embase, ERIC, Ovid MEDLINE(R), and PsycINFO The individual online journals.
Between the first description of Mini-CEX in 1995/the first description of DOPS in 2003 and December 2016
Key words: “mini-CEX”, “mini clinical evaluation exercise”, “direct observation of procedural skills”, “work based assessment”, “workplace based assessment”, “supervised learning event”, and “supervised learning events” combined with OR 11 97

12. Method: Systematic literature review
Inclusion criteria:
Only original research articles
Only English- or German-language articles
Only undergraduate and postgraduate medical trainees
Only articles investigating Mini-CEX or DOPS conducted by medical experts in actual clinical encounters
Only articles describing the educational impact of Mini-CEX or DOPS, operationalized using Barr’s adaptation of Kirkpatrick’s four-level model
Only articles describing influencing factors on the educational impact of Mini-CEX or DOPS 12 97

13. Method: Qualitative synthesis
Authors chose an integrative approach and performed a thematic analysis.
AL and FL independently reviewed the unaltered texts of the results sections of the included studies.
Identified factors were iteratively revised, reclassified, and then coded into subthemes.
Subthemes were grouped into theme. 13 97

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Results
Twelve articles reported factors influencing. 14 97

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Result
The qualitative synthesis revealed four themes and nine subthemes.
Context
Users
Implementation
Outcome 15 97

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Result 16 97

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Result: Context
Subthemes:
Time for Mini-CEX/DOPS (nine studies): Whether trainees and supervisors have sufficient time to incorporate Mini-CEX and DOPS into their daily routine
Usability of the tools (three studies): Describes the user-friendliness of the tools’ design 17 97

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Result: users
Subthemes:
Supervisors’ knowledge about how to use Mini-CEX/DOPS (seven studies)
Supervisors’ attitude to Mini-CEX/DOPS (Five studies)
Trainees’ knowledge about Mini-CEX/DOPS (four studies)
Trainees’ perception of Mini-CEX/DOPS (six studies) 18 97

19. Result: implementation
Subthemes:
Observation (four studies): Whether direct observation takes place, and if so, whether the trainees’ performance during observation reflects their actual clinical performance.
Feedback (five studies): Whether feedback was provided, and if so, its quality, including ratings and elaboration of feedback. 19 97

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Result: Outcome
Subthemes:
Trainees’ appraisal of feedback (five studies): The trainees’ perceptions and appraisal of the feedback received in Mini-CEX/DOPS.
Educational impact: Whether the use of these tools actually shapes and supports trainees’ learning. 20 97

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Discussion
Three influencing factors were described as dichotomous.
These dichotomous influencing factors appear to act as prerequisites.
Direct observation and feedback constitute the main components of the tools.
Taking only part of the influencing factors into account would be inadequate.
There may be even more factors influencing the educational impact of Mini-CEX and DOPS. 21 97

22. Limitation & Strengths
Due to the limited data base, the model might be incomplete.
This model should be seen as preliminary in nature.
This is the first systematic synthesis.
A model which can serve as a starting point to enhance the educational impact of Mini-CEX and DOPS 22 97

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Conclusion
This model could be useful for medical educators interested in implementing Mini-CEX and DOPS or in improving the educational impact of existing programs.
Future studies could either search for further influences or validate the model. 23 97

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Notable points
Educational impact
Workplace based assessment & Reliability
High emphasis on Mini-CEX !!! DOPS???
Date of publication
Impact OR Effect 24 97

25. بزرگترین نادانی‌ها برای بشر عدم شناخت خود است. امام علی (ع)