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The long case and its modifications: a literature review
Gominda G Ponnamperuma1, Indika M Karunathilake, Sean McAleer
1Centre for Medical Education, University of Dundee, Dundee, UK. gominda@googlemail.com
Medical Education
|September 23, 2009
Summary
The traditional long case clinical examination has low reliability due to limited curriculum sampling. Modifications aim to improve assessment, but further evidence is needed to confirm their efficacy for high-stakes evaluations.
Area of Science:
- Medical Education
- Clinical Assessment
Background:
- The long case is a traditional method for assessing clinical competence.
- High-stakes assessment is crucial for medical professionals.
Purpose of the Study:
- To review literature on the suitability of the long case and its modifications for high-stakes assessment.
- To identify the strengths and weaknesses of the long case format.
Main Methods:
- Searched medical databases (2000-2008) for articles on 'long case', 'clinical examinations', and 'clinical assessment'.
- Prioritized research-based articles with empirical data over opinion pieces.
- Excluded articles on Objective Structured Clinical Examinations.
Main Results:
- Eighteen articles were reviewed, highlighting the long case's low reliability due to poor curriculum sampling.
- The primary advantage is assessing a holistic approach to patient care.
- Modifications focus on structuring format/marking, increasing examiners, observing behavior, and using more cases.
Conclusions:
- Further evidence is required to validate modifications for summative assessment.
- Future research should explore practical methods to broaden curriculum sampling and enhance reliability while preserving the holistic assessment aspect.
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