Sezen Milli Avtan
Journal of Academic Research in Medicine - 2026;16(1):36-42
Objective: This study aimed to evaluate the impact of the mini-clinical evaluation exercise (mini-CEX) on clinical competence and educational outcomes in otorhinolaryngology (ENT) training across different educational levels. Methods: A systematic review and meta-analysis was conducted in accordance with Preferred Reporting Items for Systematic reviews and Meta-analyses 2020 guidelines. PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar were searched for studies assessing the mini-CEX in ENT education. Eligible studies included pre-post or observational designs reporting quantitative outcomes. Random-effects meta-analysis was used to calculate standardized mean differences (SMD) with 95% confidence intervals (CIs). Risk of bias was assessed using NIH and Newcastle-Ottawa tools. Results: Five studies, including 506 trainees and over 2,600 mini-CEX encounters, were included. Mini-CEX implementation resulted in a large, statistically significant improvement in overall clinical competence (SMD=1.29; 95% CI 1.01-1.57; p<0.001), with moderate heterogeneity (I²=52%). Improvements were observed across all competency domains, with the largest effects in physical examination and history-taking skills. The assessment was feasible within routine clinical practice, with high levels of learner engagement and faculty acceptance. Conclusion: Mini-CEX is an effective and practical formative assessment tool for improving clinical competence in ENT training. Its integration into competency-based curricula may support sustained improvements in clinical performance.
