Oral Clinical Long Case Presentation, the Need for Standardization and Documentation

Abstract

Background: The oral presentation of the clinical long case is commonly an implied knowledge. The challenge of the presentation is compounded by the examiners‘ preferences and sometimes inadequate understanding of what should be assessed. Objectives: To highlight the different opinions and misconceptions of trainers as the basis for improving our under standing and assessment of oral presentation of the clinical long case. Methodology: Questionnaire was administered during the West African College of Surgeons fellowship clinical examinations and at their workplaces. Eligibility criteria included being a surgeon, a trainer and responding to all questions. Results: Of the 72 questionnaires that were returned, 36(50%) were eligible for the analysis. The 36 respondents were from 14 centers in Nigeria and Ghana. Fifty-two percent were examiners at the postgraduate medical colleges and 9(25%) were professors. Eight(22.2%) indicated they were unaware of the separate methods of oral presentation for different occasions while 21( 58.3%) respondents were aware that candidate used the "5Cs" method and the traditional compartmentalized method in long case oral presentation. Eleven(30.6%) wanted postgraduates to present differently on a much higher level than undergraduate despite not encountering same in literature and 21(58.3%) indicated it was an unwritten rule. Seventeen (47.2%) had not previously encountered the ”5Cs" of history of presenting complaint in literature also 17(47.2%) teach it to medical students and their junior residents. Conclusion:This study has shown that examiners definitely have varying opinions on what form the oral presentation of the clinical long case at surgery fellowship/professional examination should be and it translates to their expectations of the residents or clinical students. This highlights the need for standardization and consensus of what is expected at a formal oral presentation during the clinical long case examination in order to avoid subjectivity and bias.