Teaching and assessment of core residency competencies by Ophthalmic Clinical Evaluation Exercise (OCEX)

Introduction: The Ophthalmic Clinical Evaluation Exercise (OCEX) checklist is like mini-CEX developed for ophthalmology by American Board of Internal Medicine's Clinical Evaluation Exercise. It is a validated checklist used to observe resident-patient interactions. Most of the assessments during residency program are based on cognitive domain and lack psychomotor and affective domain. The present study assessed the utility of OCEX as a learning and assessment tool for ophthalmology residents. Material and Methods: This study was carried out in ophthalmology department of NKP SIMS & LMH Nagpur for a period of six months. It was a Quasi Experimental (Before and after) study. Seven ophthalmology residents (second or third year of residency) participated in the study. Each resident had three OCEX encounters, four weeks apart over the period of three months. Two faculty members were assessors for OCEX encounters. Data was collected on interview skills, clinical examination, interpersonal skills (professionalism) and case presentation. The performance was rated and feedback was shared with resident after every encounter. Results: On analysing the results, it was found that there was a significant difference in the performance of residents between initial and final OCEX encounter. Statistical significance was measured using Friedman ANOVA test for difference in mean performance score between initial and final encounter. Faculty and students had good satisfaction with OCEX system of learning cum assessment tool. Conclusion: The present study demonstrated that OCEX leads to clinical competency improvement in ophthalmology residents by providing critical formative feedback immediately after the encounter. The resident feedback towards OCEX was favourable.