The Teamwork Mini-Clinical Evaluation Exercise (T-MEX): A Workplace-Based Assessment Focusing on Collaborative Competencies in Health Care

Olupeliyawa, Asela M. PhD; O’Sullivan, Anthony J. MD; Hughes, Chris PhD; Balasooriya, Chinthaka D. PhD

doi: 10.1097/ACM.0000000000000115
Research Reports

Purpose: Teamwork is an important and challenging area of learning during the transition from medical graduate to intern. This preliminary investigation examined the psychometric and logistic properties of the Teamwork Mini-Clinical Evaluation Exercise (T-MEX) for the workplace-based assessment of key competencies in working with health care teams.

Method: The authors designed the T-MEX for direct observation and assessment of six collaborative behaviors in seven clinical situations important for teamwork, feedback, and reflection. In 2010, they tested it on University of New South Wales senior medical students during their last six-week clinical term to investigate its overall utility, including validity and reliability. Assessors rated students in different situations on the extent to which they met expectations for interns for each collaborative behavior. Both assessors and students rated the tool’s usefulness and feasibility.

Results: Assessment forms for 88 observed encounters were submitted by 25 students. The T-MEX was suited to a broad range of collaborative clinical practice situations, as evidenced by the encounter types and the behaviors assessed by health care team members. The internal structure of the behavior ratings indicated construct validity. A generalizability study found that eight encounters were adequate for high-stakes measurement purposes. The mean times for observation and feedback and the participants’ perceptions suggested usefulness for feedback and feasibility in busy clinical settings.

Conclusions: Findings suggest that the T-MEX has good utility for assessing trainee competence in working with health care teams. It fills a gap within the suite of existing tools for workplace-based assessment of professional attributes.

Dr. Olupeliyawa is lecturer, Medical Education Development and Research Centre, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka. At the time of writing, he was a doctoral candidate, School of Public Health and Community Medicine, UNSW Medicine, University of New South Wales, Sydney, Australia.

Dr. O’Sullivan is program authority, UNSW Medicine, and associate professor, Department of Medicine, St. George Clinical School, UNSW Medicine, University of New South Wales, Sydney, Australia.

Dr. Hughes is associate professor, Rural Clinical School, UNSW Medicine, University of New South Wales, Sydney. Australia.

Dr. Balasooriya is director, Medical Education Development, and senior lecturer, School of Public Health and Community Medicine, UNSW Medicine, University of New South Wales, Sydney, Australia.

Funding/Support: This research was part of Dr. Olupeliyawa’s doctoral research project. He was awarded the Australia and New Zealand Association for Medical Education (ANZAME) Postgraduate award, the UNSW Medicine Innovations in Learning & Teaching award, and a UNSW PhD completion scholarship.

Other disclosures: None reported.

Ethical approval: Ethical approval was obtained from the Human Research Ethics Advisory Panel, UNSW, as per ethical guidelines for conducting research in Australia (HREA reference no: 2010-7-29).

Previous presentations: A preliminary analysis of the psychometric and logistic data of this study was presented at the annual conference of the Australia and New Zealand Association for Health Professional Educators; July 2011; Alice Springs, Australia.

Supplemental digital content for this article is available at http://links.lww.com/ACADMED/A178.

Correspondence should be addressed to Dr. Olupeliyawa, Medical Education Development and Research Centre, Faculty of Medicine, 25, Kynsey Road, Colombo-08, Sri Lanka; telephone: +94112695300; e-mail: asela_o@yahoo.com.

© 2014 by the Association of American Medical Colleges