# Comparative Evaluation of Structured Clinical Case Examination Versus Traditional Long Case Examination for Assessing Clinical Competence in Pediatric Patients in India: A Quasi-experimental Study

## TL;DR

This study compares two methods for evaluating medical students' clinical skills in pediatrics, finding that a structured approach yields better results and student satisfaction.

## Contribution

The study introduces and evaluates a structured clinical case examination as a more effective alternative to traditional assessments in medical education.

## Key findings

- Students scored significantly higher in SCCE compared to TLCE.
- A higher proportion of students passed and achieved good/excellent marks in SCCE.
- Students perceived SCCE as clearer and more inclusive of communication skills.

## Abstract

Purpose: Due to subjectivity, traditional long cases present challenges in assessing clinical acumen. Implementing the Objective Structured Long Examination Record to tackle these concerns presents practical challenges. These challenges lead to considering the Structured Clinical Case Examination (SCCE) as a middle ground. This article aims to answer how clinical competence assessment in pediatrics differs when using a Structured Clinical Long Case Examination rather than a Traditional Long Case Examination (TLCE).

Methods: This study was conducted at the Subbaiah Institute of Medical Sciences, Shivamogga. The study focused on 133 final-year MBBS undergraduates during their pediatric posting. Students were assessed using TLCE and SCCE by two different faculties on the same day using a validated checklist for SCCE. The students’ perceptions were collected via a questionnaire. The paired sample t-test compared TLCE and SCCE scores for a comprehensive evaluation.

Results: The paired sample t-test revealed a significant increase in marks obtained in SCCE (mean = 29.8, standard deviation, SD = 5.4) compared to TLCE (mean = 26.7, SD = 5.9) (t = 7.21, p < 0.001). Notably, 84.2% of students passed SCCE, compared to 69.9% passing TLCE. A higher proportion of students scored good (31.5%) and excellent (21.8%) marks in SCCE compared to TLCE (18.7% for good, 10.5% for excellent). Feedback from a Likert-scale questionnaire indicated strong student agreement with SCCE (χ² = 13.7, p = 0.008).

Conclusion: SCCE appears to be a useful structured method for assessing the clinical competency of final-year medical students, offering a more organized evaluation of diverse clinical skills. Students reported favorable perceptions of SCCE, particularly regarding clarity of expectations and inclusion of communication skills. In conclusion, SCCE's structured, observational approach has the potential to address inadequacies in clinical evaluation and enhance clinical skill learning in graduates. Further studies are needed to confirm its broader applicability and effectiveness.