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Meeting international standards: A cultural approach in implementing the mini-CEX effectively in Indonesian clerkships

机译：符合国际标准：在印度尼西亚文员中有效实施小型CEX的一种文化方法

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Background: Medical schools all over the world try to adapt their programs to meet international standards. However, local culture might hamper innovation attempts. Aims: To describe challenges in implementing the mini-CEX in Indonesia and investigate its effect on students' clinical competence. Methods: The study was conducted in the Internal Medicine and Neurology departments of the Universitas Gadjah Mada, Indonesia. Implementing the mini-CEX into the existing curriculum, while taking the Indonesian culture into account, implied a shift from group to individual feedback. We compared students' final clinical competence before (Internal Medicine n=122, Neurology n=183) and after (n=183 and 186, respectively) the implementation of the mini-CEX, using a modified Objective Structured Long Examination Record (OSLER). The Mann-Whitney test was used to analyze the data. Results: We took power distance and individualism into account to facilitate the implementation process. After implementing the mini-CEX, the OSLER results were significant higher in Internal Medicine (p<0.05). However, no differences were found in Neurology. Conclusion: By managing the innovation process carefully and taking culture and local context into account, the mini-CEX can be implemented without changing the underlying concept. The shift from group to individual feedback seems to have a positive effect on student learning.
机译：背景：世界各地的医学院校都在努力调整其课程以符合国际标准。但是，当地文化可能会阻碍创新尝试。目的：描述在印度尼西亚实施小型CEX所面临的挑战，并研究其对学生临床能力的影响。方法：该研究是在印度尼西亚加贾玛达大学的内科和神经科进行的。将小型CEX实施到现有课程中，同时考虑到印尼文化，这意味着从集体反馈转向个人反馈。我们使用修改后的客观结构长期考试记录（OSLER）比较了mini-CEX实施之前（内部医学n = 122，神经内科n = 183）和之后（分别为n = 183和186）学生的最终临床能力。 。使用Mann-Whitney检验分析数据。结果：我们考虑了权力距离和个人主义，以促进实施过程。实施mini-CEX后，内科医师的OSLER结果显着更高（p <0.05）。但是，在神经内科方面没有发现差异。结论：通过谨慎地管理创新过程并考虑文化和当地背景，可以在不更改基本概念的情况下实施mini-CEX。从小组反馈到个人反馈似乎对学生的学习产生了积极影响。

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