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The case for resurrecting the long case

BMJ 2008; 336 doi: (Published 29 May 2008) Cite this as: BMJ 2008;336:1250
  1. Narci C Teoh, senior lecturer in medicine1,
  2. Francis J Bowden, professor of medicine1
  1. 1Australian National University Medical School at The Canberra Hospital, Canberra
  1. Correspondence to: F J Bowden frank.bowden{at}

    Reports of the death of the long case as a tool for assessing medical students’ clinical skills may be greatly exaggerated.1 Unfortunately, the unintended consequence of highlighting its poor inter-case reliability is that even the judicious use of the long case may be seen as being out of touch with modern educational practice. In the ongoing struggle to improve the reliability of our assessment of students, we may forget that knowing that a student will be examined in a particular way determines that student’s learning behaviour.

    Firstly, a definition: at our school a long case is where a student sees a real patient in a clinical setting, takes a history, examines the patient, makes a diagnosis, formulates a management plan, and then presents this information and discusses the issues arising from the case with a clinical tutor. Each long case is marked against a set of criteria and graded. Students must complete 14 long cases over two …

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