Perceived educational impact of the medical student long case: a qualitative study

BACKGROUND: The long case is a traditional method of clinical assessment which has fallen out of favour in certain contexts, primarily due to psychometric concerns. This study explored the long case’s educational impact, an aspect which has been neglected in previous research. METHODS: Three focus groups of medical students (20 in total) and semi-structured interviews of six examiners were conducted. Cook and Lineberry’s framework for exploring educational impact was used as a sensitising tool during thematic analysis of the data. RESULTS: Participants described the long case and its scoring as having influence on student learning. Engaging in the activity of a long case had an essential role in fostering students’ clinical skills and served as a powerful driving force for them to spend time with patients. The long case was seen as authentic, and the only assessment to promote a holistic approach to patients. Students had concerns about inter-case variability, but there was general consensus that the long case was valuable, with allocation of marks being an important motivator for students. CONCLUSIONS: This study offers a unique focus on the traditional long case’s educational consequences; the extent of its positive impact would support its place within a program of assessment.