Reliability and validity of long case and short case in internal medicine board certification examination

Objective: To be certified for the Thai Board of Internal Medicine, each candidate must pass both written and clinical examinations performed in different academic years. The present study aimed to assess the reliability and validity of the long case and short case which contribute major fractions in the clinical part of board certifying examination. Material and Method: Data from 585 internal medicine residents entering a first-attempt clinical part in board certifying examination during the academic year 2005-2007 were collected. Inter-rater reliability and construct validity of the long case and short case were then examined. Results: Good to excellent intraclass correlation (ICC) of scores from different examiners was demonstrated (ICC between 0.71 and 0.97) and the variation ranged from 15.3 to 27.3%. For different occasions of examination, class normalized gain was between -0.7 and -9.0% and negative individual normalized gain was observed in 45.6% to 48.2% of the candidates. Conclusion: Acceptable inter-rater reliability was demonstrated in long case and short case in clinical examination for the Thai Board of Internal Medicine. But construct validity for this type of clinical assessment was not established.