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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:
Participants will:
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Occupational Therapy Fieldwork Interns | This group includes occupational therapy interns specializing in the physical domain who are undergoing fieldwork training at Far Eastern Memorial Hospital. Participants are recruited during their sixth week of internship and assessed at the eighth week. The study evaluates their fieldwork performance using Mini-Clinical Evaluation Exercise (Mini-CEX) and Entrustable Professional Activities (EPAs) as standard assessment tools. Participation is voluntary with informed consent, and no additional interventions beyond routine fieldwork training are applied. Data collected will be used to analyze the relationship between these assessment tools and interns' readiness for independent practice. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Mini-Clinical Evaluation Exercise (Mini-CEX) and Entrustable Professional Activities (EPAs) Assessment | Other | 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. |
| Measure | Description | Time Frame |
|---|---|---|
| Independent Clinical Competence of Occupational Therapy Interns | The primary outcome is the assessment of occupational therapy interns' independent performance during fieldwork, measured by combined scores of the Mini-Clinical Evaluation Exercise (Mini-CEX) and Entrustable Professional Activities (EPAs). The Mini-CEX evaluates seven core clinical competencies, scored from 1 to 9 per item, with higher scores indicating better clinical performance. EPAs assess competence based on supervision levels, scored from 1 to 5, where higher scores reflect greater independence and readiness for unsupervised clinical practice. This combined assessment captures interns' clinical skills, decision-making, and preparedness for independent work. | Assessment conducted at the eighth week of internship fieldwork. |
| Measure | Description | Time Frame |
|---|---|---|
| Correlation of Demographic Factors with fieldwork Competence | Analysis of demographic variables including age, gender, average study time, prior university experience, parental occupation, and residence area, to explore their association with interns' performance on Mini-CEX and EPAs assessments. | Data collected and analyzed at the eighth week of internship. |
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Inclusion Criteria:
Exclusion Criteria:
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This study population consists of occupational therapy interns undergoing physical domain fieldwork at Far Eastern Memorial Hospital. Participants are typically fourth-year students engaged in clinical internship training.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Chao Yi Cheng, MS | Contact | +886-2-8966-7000 ext. 1516 | xero1118@gmail.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Far Eastern Memorial Hospital | New Taipei City | 220 | Taiwan |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 26172347 | Background | 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. | |
| 33882926 | Background | 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. |
| Label | URL |
|---|---|
| Official website of the rehabilitation research team. This site does not currently contain detailed information about this specific study. For study-related inquiries, please contact the research team directly. | View source |
| ID | Type | URL | Comment |
|---|---|---|---|
| Study Protocol | View IPD |
This study will not share individual participant data (IPD) due to considerations related to participant privacy and confidentiality. The data collected involve sensitive personal and demographic information of occupational therapy interns, and sharing such data could risk identification despite de-identification efforts. Additionally, the study was conducted under ethical approvals that restrict data sharing beyond the research team. Aggregate results and summary findings will be made publicly available through publications and ClinicalTrials.gov, ensuring transparency while protecting participant rights.
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Mar 10, 2025 | Jul 30, 2025 |
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|
| Background | 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. https://doi.org/10.6594/tjot.202308_41(2).0001 |
This document contains the study protocol and statistical analysis plan for the cross-sectional study assessing Mini-CEX and EPAs in occupational therapy interns. |
| Prot_000.pdf |
| ICF | No | No | Yes | Informed Consent Form | Mar 10, 2025 | Jul 30, 2025 | ICF_001.pdf |
| ID | Term |
|---|---|
| D012149 | Restraint, Physical |
| ID | Term |
|---|---|
| D032763 | Behavior Control |
| D013812 | Therapeutics |
| D007103 | Immobilization |
| D008919 | Investigative Techniques |
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