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The observed long-case in clinical assessment.
1Department of Medicine, University of Adelaide, Australia.
Medical Education
|September 1, 1991
Summary
The University of Adelaide improved clinical assessment by using ward ratings and objective exams. Modified vivas with observed long-cases enhanced decision-making and examiner agreement, offering a practical alternative.
Area of Science:
- Medical Education
- Clinical Assessment
Background:
- Traditional clinical assessment methods can present challenges in decision-making.
- The University of Adelaide sought to refine its final-year clinical assessment process.
Purpose of the Study:
- To develop and evaluate a comprehensive approach to final-year clinical assessment.
- To improve the reliability and effectiveness of clinical competence evaluation.
Main Methods:
- Implemented ward ratings during student internships.
- Administered objective examinations of clinical competence.
- Modified the traditional clinical viva to include two observed long-cases per student.
- Introduced observed long-cases into the ward setting.
Main Results:
- Observed long-cases in vivas led to better examiner agreement and more effective decision-making.
- The approach, including observed long-cases in wards, received strong support from staff and students.
- Remedial action opportunities were considered particularly valuable.
Conclusions:
- The developed approach offers a practical alternative to sophisticated assessment techniques like standardized patients.
- The method may be implemented without additional resources.
- Further psychometric studies are required for full recommendation.