Exploring the Relationship Between Mini-Clinical Evaluation Exercise (Mini-CEX) and Entrustable Professional Activities (EPAs) in Occupational Therapy Clinical Interns' Independent Competence

Official title

Entrustable Professional Activities and Mini-Clinical Evaluation Exercise in a Simulated Workplace-based Assessment for Physical Occupational Therapist Intern

Overview

The goal of this observational cross-sectional study is to evaluate whether the combined use of Mini-Clinical Evaluation Exercise (Mini-CEX) and Entrustable Professional Activities (EPAs) can assess the independent clinical competence of occupational therapy interns at Far Eastern Memorial Hospital. The main questions it aims to answer are: 1. Does the performance on Mini-CEX correlate with the interns' ability to perform independently? 2. Does the use of EPAs provide additional insight into interns' readiness for unsupervised clinical practice? Participants will: 1. Provide informed consent at the sixth week of their internship. 2. Undergo assessment with Mini-CEX and EPAs during their eighth week of clinical training. 3. Complete demographic questionnaires including age, gender, study habits, prior university experience, parental occupation, and residence area.

Detailed description

Medical graduates in the healthcare field apply theoretical knowledge gained during their education combined with clinical supervision to develop professional skills necessary for patient care. To comprehensively evaluate interns' professional competence during clinical training, workplace assessment tools such as the Mini-Clinical Evaluation Exercise (Mini-CEX) are commonly used. Mini-CEX, developed by the American Medical Association, assesses seven core clinical skills over a 20 to 30-minute observation period. However, Mini-CEX alone may not fully capture the interns' ability to perform independently.

Competency-Based Medical Education (CBME) emphasizes the development of core competencies, and Entrustable Professional Activities (EPAs) have been proposed as a framework to describe tasks that trainees should be entrusted to perform unsupervised at various training stages. EPAs assess the level of supervision required, reflecting the degree of trust clinical supervisors place in trainees. In Taiwan, EPAs tailored for occupational therapy have been developed and implemented under the guidance of the Occupational Therapy Association.

This study aims to explore the relationship between Mini-CEX and EPAs in evaluating occupational therapy interns' independent clinical competence. The study will recruit 50 interns from the physiological domain of occupational therapy at Far Eastern Memorial Hospital over four years. Participants will be recruited at the sixth week of their internship, provide informed consent, and be assessed at the eighth week using both Mini-CEX and EPAs. The assessments are part of routine clinical training evaluations and take approximately 20 minutes.

Data collected will include demographic information and assessment scores. Statistical analyses will involve descriptive statistics, Pearson correlation to examine relationships between variables, and multiple linear regression to identify predictors of clinical performance, including age, gender, study habits, prior university experience, parental occupation, and residence area. Participation is voluntary and will not affect interns' clinical training or evaluation outcomes.

This study seeks to provide evidence on whether combining Mini-CEX and EPAs offers a more reliable assessment of interns' readiness for independent clinical practice, potentially informing future educational strategies in occupational therapy training.

Interventions

• Other Mini-Clinical Evaluation Exercise (Mini-CEX) and Entrustable Professional Activities (EPAs) Assessment
  Participants undergo standard fieldwork assessments using Mini-CEX and EPAs during their internship to evaluate fieldwork competence and readiness for independent practice. These are observational assessments without additional experimental interventions.

Primary outcome measures

• Independent Clinical Competence of Occupational Therapy Interns [Time frame: Assessment conducted at the eighth week of internship fieldwork.]

Secondary outcome measures (1)

• Correlation of Demographic Factors with fieldwork Competence [Time frame: Data collected and analyzed at the eighth week of internship.]

Eligibility criteria

Inclusion criteria

• Occupational therapy interns in the physical domain at Far Eastern Memorial Hospital
• Provide informed consent to participate

Exclusion criteria

• None specified

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: Yes

Study design

Observational model

Other

Study locations

Taiwan · 1 center

• Far Eastern Memorial Hospital — New Taipei City

Publications

• Ten Cate O, Chen HC, Hoff RG, Peters H, Bok H, van der Schaaf M. Curriculum development for the workplace using Entrustable Professional Activities (EPAs): AMEE Guide No. 99. Med Teach. 2015;37(11):983-1002. doi: 10.3109/0142159X.2015.1060308. Epub 2015 Jul 14. PMID 26172347
• Pinilla S, Kyrou A, Kloppel S, Strik W, Nissen C, Huwendiek S. Workplace-based assessments of entrustable professional activities in a psychiatry core clerkship: an observational study. BMC Med Educ. 2021 Apr 21;21(1):223. doi: 10.1186/s12909-021-02637-4. PMID 33882926
• Fu, C. P., Chiang, F. M., Lee, C. Y., Chi, H. Y., Wu, J. L., Lin, Y. J., Li, M. W., Chen, Y. J., Chang, W. Y., Chang, W. D., Huang, S. M., Liao, W. S., Yang, Y. C., Huang, C. K., Kuo, N. J., Liu, T. H., & Chen, Y. L. (2023). Developing the topics of entrustable professional activities in pediatric occupational therapy in Taiwan: A pilot study. Taiwan Journal of Occupational Therapy, 41(2), 91-110.

Identifiers

NCT: NCT07107542 · 114026-E

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗