Kumakech Jacob, Munabi Ian Guyton, Mubuuke Aloysius Gonzaga, Kiguli Sarah
School of Medicine, Department of Paediatrics & Child Health, Makerere University, Kampala, Uganda.
School of Biomedical Sciences, Department of Anatomy, Makerere University, Kampala, Uganda.
BMC Med Educ. 2025 Apr 22;25(1):588. doi: 10.1186/s12909-025-07055-4.
The long case is a historical clinical assessment method for medical students but is being phased out due to low reliability arising from the difficulty in standardization of the assessment. However, it's an educationally valuable assessment, whose consequential validity has got little attention in the literature.
The aim of the study was to explore the consequential validity of the long case as perceived by medical students and lecturers.
The study followed an interpretivist approach utilizing qualitative methods of data collection. Data was collected through Focus Group Discussions with medical students (n = 6) as well as Key Informant Interviews with lecturers (n = 5). The qualitative data was analyzed by deductive qualitative analysis utilizing Cook and Lineberry framework for evaluating the educational impact of an assessment.
RESULTS & DISCUSSION: The study found that the long case is an educationally valuable assessment method because it is authentic and provides a holistic approach to clinical assessment. The assessment promotes professional identity development as students assume the role of a physician. Though reliability was reported as the main weakness of the long case, participants were strongly in favor of the long case especially for formative assessment. It was also noted that awarding marks in the formative assessment serves as a major incentive for students to do more long cases. Though, the study reported patients being uncooperative to students sometimes, it lacked the voices of the patients yet they are a major player during the long case assessment.
The long case is an educationally valuable assessment for formative evaluation of medical students and offers great potential for professional development.
长病例是医学生使用的一种历史悠久的临床评估方法，但由于评估标准化困难导致可靠性较低，正逐渐被淘汰。然而，它是一种具有教育价值的评估方式，其结果效度在文献中很少受到关注。
本研究旨在探讨医学生和讲师所感知的长病例的结果效度。
本研究采用解释主义方法，运用定性数据收集方法。通过与医学生（n = 6）进行焦点小组讨论以及与讲师（n = 5）进行关键 informant 访谈来收集数据。利用库克和林贝里框架对定性数据进行演绎定性分析，以评估评估的教育影响。
研究发现，长病例是一种具有教育价值的评估方法，因为它真实且提供了一种全面的临床评估方法。随着学生承担医生的角色，该评估促进了职业身份的发展。尽管可靠性被报告为长病例的主要弱点，但参与者强烈支持长病例，特别是用于形成性评估。还指出，在形成性评估中打分是激励学生进行更多长病例评估的主要动力。不过，研究报告称患者有时对学生不合作，而且研究缺乏患者的声音，然而他们在长病例评估中是主要参与者。
长病例对于医学生的形成性评估具有教育价值，并为职业发展提供了巨大潜力。
