🧠 COTs & Mini-CEXs Made Easy

   

Mini-CEXs and COTs are two of the core tools used in GP training to assess your consultation skills in real time. They’re part of the mandatory Workplace-Based Assessments (WPBAs), and you’ll complete several of each during your ST1–ST3 years.

This guide breaks down what they are, how they differ, how many you need, and how to get them done.

     

🧾 What’s the Difference? COT vs CEX

✅ COT (Consultation Observation Tool)

• Used in GP placements only
  
• Assesses consultations in real-time or via recording
• Includes in-person, video, and telephone consultations (Audio-COT)
• Focuses on core GP consulting skills and professionalism

✅ Mini-CEX (Mini Clinical Evaluation Exercise)

• Used in non-GP placements (i.e. hospital jobs) only
• Observed real-life interaction with a patient
• Assesses communication, professionalism, clinical judgment, and efficiency
• Typically completed by your hospital clinical supervisor

💡 The COT is essentially a more general practice–focused version of the Mini-CEX.

         

📆 How Many Do I Need?

Training Year	Requirement	Notes
ST1	Minimum 4 COTs and/or Mini-CEXs	e.g. 2 COTs, 2 CEXs
ST2	Minimum 4 COTs and/or Mini-CEXs	E.g. 3 COTs, 1 CEX
ST3	Minimum 7 COTs	No CEXs in ST3 as GP placement only

           

🔍 How Do They Work in Practice?

🗂️ COTs (Including Audio-COTs)

COTs are completed during GP placements and focus on your consulting skills in real or recorded patient encounters. All use the same FourteenFish form - except Audio-COTs, which have a separate template specifically for telephone consultations.

Types of consultations you can submit:

• In-person (live or recorded)
• Remote/video consultations (live or recorded)
• Telephone consultations (Audio-COT)

Your supervisor will assess your consultation against one or more of the 13 Capabilities and provide feedback on what you did well and where to improve.

📝 Always make sure you get consent before recording any patient encounter, and document this clearly within the notes.

📎 Click here to download the COT form from the RCGP

📎 Click here to download the CEX form from the RCGP

📎 Click here to download the Audio-COT form from the RCGP

                 

🧑‍⚕️ Mini-CEX (Hospital Placements)

Mini-CEX assessments are completed during non-GP (i.e. hospital) placements, and involve direct observation by a supervisor or another senior clinician (e.g. often the SpR you are on-call with). They allow feedback on skills such as

• Communication and consultation
• Clinical judgement and decision-making
• Professionalism

     

✍️ How to Complete a COT / Audio-COT / Mini-CEX on FourteenFish

The process is straightforward for all three. 

1. From the main Portfolio dashboard, follow these steps
2. Scroll down to ‘Educational Assessments’
3. Select COTs / Audio-COTs / Mini-CEX
4. Scroll to ‘Request an assessment’
5. Choose the desired form

Then:

Step 1: Invite Your Assessor

• Select from your existing FourteenFish contacts
• Or invite a new colleague by entering their name, role, and email

Step 2: Fill in the Case Details

Assessment Type	What you need to fill in
COT	Title, date, short case description
Audio-COT	Title only
Mini-CEX	Title, date, short case description

Step 2: Send a ticket

• Once completed, send it to your supervisor for review.
• If they’re slow to respond, you can send an email or a reminder via FourteenFish, using the ‘Resend invite’ function. 

💡 As always - try to be organised and spread your CEXs and COTs evenly throughout your placement. Avoid leaving them all to the last month or it can be stressful finding someone to complete your assessments. 

      

🔑 Why It Matters

These assessments can sometimes feel like just another hoop to jump through - but they’re valuable tools to build your confidence and get feedback on your consulting style. 

      

✅ Ready to Stay Organised?

Keeping track of your Mini-CEXs, COTs, and Audio-COTs can be a pain - especially when juggling multiple placements and deadlines.

That’s why we’ve made it easier for you:

📥 Download our free WPBA Checklist PDF [COMING SOON]
Track what you’ve done, what’s left to do, and stay on top of your portfolio all year long.

🔗 Click here to download your checklist [COMING SOON]

💡 Pin it to your desktop. Print it out. Tick things off as you go - future you will thank you.