Mini-Clinical Evaluation Exercise (Mini-CEX)

The Mini-Clinical Evaluation Exercise (Mini-CEX) is a Workplace-Based Assessment (WBA) tool used by the AMC to evaluate a candidate’s clinical skills in a real patient encounter.

During a Mini-CEX, the assessor directly observes the candidate’s interaction with a patient during a focused clinical task, provides immediate structured feedback, and records the performance on a standardised form.

This assessment promotes reflective practice, clinical learning and progressive improvement.

The Mini-CEX is designed to assess a candidate’s ability to apply clinical and communication skills in real settings, including demonstrating professional and culturally safe practice. It supports supervisors in judging overall competence and provides opportunities for formative learning.

Benefits include:

• Assessment of real-world performance rather than theoretical knowledge
• Immediate, specific and constructive feedback
• Promotion of reflective learning and skill development
• Evidence of performance across multiple disciplines

Level of assessment: that of a graduate of an AMC-accredited medical program at the end of postgraduate year one (PGY1/internship).

Disciplines assessed:

• Adult Health – Medicine
• Adult Health – Surgery
• Emergency Medicine
• Women’s Health
• Child Health
• Mental Health

Assessment requirements:

• Candidates complete 12 Mini-CEX assessments and must cover two in each clinical area. The passing requirement is nine out of twelve and at least one in each clinical area.

Observation: The candidate requests an assessor (consultant or advanced trainee) to observe a real patient encounter.

Duration: The focused clinical task generally takes less than 20 minutes, followed by an immediate feedback session.

Feedback and action planning: The assessor provides verbal feedback, identifies strengths and development areas, and helps the candidate create a short-term learning plan.

The Mini-CEX evaluates multiple domains of clinical practice, including:

History taking: Eliciting accurate and relevant information, identifying key problems and context.

Physical examination: Logical, focused examination, correct technique, interpretation of findings and communication with the patient.

Counselling, education and management: Communicating clearly and respectfully; demonstrating cultural awareness; managing informed consent; providing evidence-based advice and patient education.

Clinical reasoning: Integrating information, forming differential diagnoses and prioritising patient safety.

Communication and professionalism: Using clear language, listening effectively, demonstrating empathy, respect and cultural safety.

Organisation and efficiency: Managing time and resources effectively in a clinical setting.

Performance is recorded on the AMC Mini-CEX Assessment Form, which includes rating scales and written feedback sections.

The form captures:

1. Details of the candidate, assessor and encounter.
2. Ratings across the assessed clinical domains.
3. Global performance rating benchmarked against the expected level of a graduate of an AMC-accredited medical program at the end of PGY1.
4. Assessor’s written comments and feedback summary.

Both assessor and candidate sign the form after feedback.

Before conducting a Mini-CEX, assessors should refer to the online resources and any required WBA program training or calibration exercises.

These resources support calibration and quality assurance, showing what effective observation, feedback and rating look like in a Mini-CEX.

They also assist IMG candidates by providing examples of how clinical skills, communication, professionalism and reasoning are demonstrated and assessed during a Mini-CEX encounter.

Mini-CEX: Medicine – History Taking

Case Summary
A 54-year-old man presents to his GP with chest discomfort and shortness of breath on exertion. His symptoms are suggestive of stable angina, but alternative diagnoses such as gastrointestinal bleeding leading to anaemia are considered. The candidate performs a focused cardiovascular history, demonstrating systematic questioning, clinical reasoning and rapport-building, while the assessor observes the interaction.

Duration: 3 minutes 51 seconds

Mini-CEX: Women’s Health – Counselling for First Trimester Bleeding

Case Summary
A woman approximately 6–8 weeks pregnant presents to the Emergency Department with light vaginal bleeding and mild cramping. The candidate reviews the findings of an early pregnancy assessment and provides structured, empathetic counselling about likely causes, including threatened miscarriage and other differentials such as ectopic pregnancy. The consultation focuses on reassurance, patient-centred communication and explaining next steps, including ultrasound and follow-up.

Duration: 8 minutes 54 seconds

Additional resources

• Must be based on real patient encounters.
• Conducted face-to-face and observed directly.
• Immediate feedback and documentation are mandatory.
• Minimum numbers and discipline coverage must be met.
• All sections of the form, including signatures and written feedback, must be completed.