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The ability of a long-case assessment in one discipline to predict students' performances on long-case assessments in other disciplines.

PURPOSE
To determine whether medical students' performances in a long-case assessment in one of four disciplines (internal medicine, pediatrics, reproductive medicine, or surgery) could predict later performances in long-case assessments in the other disciplines.


METHOD
In their fourth of five years at the University of Newcastle, at the end of 12-week rotations in internal medicine, pediatrics, surgery, and reproductive medicine, students undertake long-case assessments. Each long-case assessment involves a real patient and a vive voce examination, and each is scored by two assessors. The author reviewed these scores, which could range from 5 to 20, for the years 1992 to 1997.


RESULTS
Over the six years, 391 students completed 1,564 cases. In 249 cases, the students scored better than 11 on their first long-case assessments; of those, 16 (6.5%) went on to fail one of the three subsequent assessments. Of the 142 students who scored 10 or less on their first assessments, 25 (17.6%) went on to fail one of the subsequent three, and 9 (6.3%) went on to fail two more assessments. Of the 24 students who scored 10 or less on the first two assessments, 9 (37.5%) went on to fail one of the next two. There were statistically significant correlations among scores in all disciplines.


CONCLUSIONS
Performance in any one of the four disciplines was a good predictor of performance in any other discipline. Except for borderline students, one case was almost as good a predictor as three, and for borderline or weak students two cases were nearly as good as three.