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Mini CEX

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COLLEGE OF

OF PHYSICIANS AND
SURGEONS PAKISTAN
MINI CLINICAL EVALUATION
EXERCISE (CEX)
Specialty: ___FCPS (IMM & Post-IMM) Prosthodontics_____

Time Duration = 20 mins (15 mins assessment and 5 mins feedback)


PLEASE COMPLETE THE QUESTIONNAIRE BY FILLING/CHECKING APPROPRIATE BOXES

Assessor:______________________________________________Assessment Date:

________________________

Resident's Name:

_____________________________________________________________________________________

Hospital Name:_________________________________________R&RC Number:

__________________________

Year of Residency: □ R1 □ R2 □ R3 □ R4

Quarter: □ 1st □ 2nd □ 3rd □ 4th

Setting: □ Ward □Outdoor (Hospital/Community) others: _________________________________

Diagnosis of Patient:_____________________________________Patient Age:_________Sex:

_______________

Clinical Area:

_________________________________________________________________________________________

Complexity of Case/ Procedure: □ Low/Easy □ Moderate/Average □ High/Difficult □ N/A

Focus of Clinical Encounters:□ History taking □ Physical Examination □Management

□ Communication Skills □ Other

Not Observed / Below Expectation Satisfactory Above Expectation Excellent


Please grade the following areas on the given scale: Applicable
1 2 3 4 5
Informed Consent of patient

Interviewing Skills

Systematic Progression

Presentation of positive & significant negative findings

Justification of actions

Professionalism

Organization/Efficiency

Overall clinical competence


Assessor's Satisfaction with Mini-CEX:
(Low) 1 2 3 4 5 (High)
Resident's Satisfaction with Mini-CEX:
(Low) 1 2 3 4 5 (High)

Strengths Suggestions for Improvements

Encounter to be repeated □ YES □ NO

Signature

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