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Long and short cases

In the traditional long case the holistic appraisal of the examinee’s ability to interact with, assess and manage a real patient is a laudable goal and contributes to the face validity of this method.  However, in recent years there has been much criticism of this approach related to variations in examiner stringency, unstructured questioning and global marking without anchor statements and patient variability - in information disclosure, demeanour, comfort and health.  Perhaps more importantly, examinees’ clinical skills may vary significantly across cases, so that assessing examinees on one patient cannot not provide generalizable estimates of a candidate’s overall ability (Norcini,2001, 2002).

Although apparently similar to an OSCE in providing a larger range of short cases, the differences between short cases and an OSCE are that different students rarely see the same patients, cases differ in their complexity, the same two assessors examine the student at each case, the examination is not structured and the examiners are free to ask any questions they wish. These factors result in poor reliability of this method and OSCEs have superseded this genre of assessment.

See the module Workplace-based assessments for more information on different types of clinical assessments.

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