A comparative study of the traditional long case with the objective structured clinical examination in Lagos, Nigeria.

An apparent difference in the results of the clinical examination of the final M.B., B.S. was observed following replacement of the traditional long case (TLC) with the Objective Structured Clinical Examination (OSCE) in 1979. This led to a study of the results of two consecutive years of each method, 1976 and 1978 (TLC), and 1979 and 1980 (OSCE). The OSCE pass rate of 61% was found to be significantly lower than TLC pass rate of 93% (P less than 0.05). Using the analysis of variance and the critical difference (CD) of the mean scores of the different types of examination, no significant difference was found to exist between the two TLC examinations or between the two OSCE examinations. However, significant difference exists between the TLC of 1978 and the OSCE of 1979, P less than 0.05. A comparison of the CD of MCQ to those of TLC and OSCE suggests that less differences exist between MCQ and OSCE scores compared to MCQ and TLC scores, and by 1980 no significant difference exists between MCQ and OSCE. OSCE, like MCQ, will therefore appear an acceptable method of examination and perhaps a more effective method of clinical examination than TLC.