ArticleIrish journal of medical science2026
Why and how the long case became the OSLER-the sum of the parts.
Article in Irish journal of medical science, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- Why and how the long case became the OSLER-the sum of the parts.Irish journal of medical science · 2026Article
Corrections and comments
- Erratum issued
Authors and funding
1 author.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The Objective Structured Long Examination Record (OSLER) was introduced in 1987 in response to critcisims of the unstructured traditional Long Case. The previously designed Objective Structured Clinical Examination (OSCE) had replaced challenges relating to the short case exam. The Long Case was criticised in relation to its Objectivity, Validity and Reliability and calls for its abandonment were voiced. Others were concerned that without a Long Case, the skill standards involved in constructing a fully integrated Long Case Record for service and medico-legal requirements would regress. As a practicing clinician and medical educator, I studied the Long Case aims and objectives, regarding its shortcomings. A formal task analysis of the Long Case resulted in the development of the now termed acronym OSLER. The core principles of the Long Case were retained, but in the form of a structured innovation. The outcome resulted in a 10-item checklist Long Case exam. A criterion referenced assessment method was assembled, and a similar approach was developed for examiners to identify case difficulty. The outcome revealed that with 2 examiners, the number of their individual and agreed assessment decisions increased from 3 per candidate to a composite of 135 per candidate. With its development and with the support of colleagues, a one-week intensive MRCP clinical skills assessment pre-exam course was established and acted as a research instrument for the OSLER development The OSLER immediately revealed poor clinical skills of the course participants. However, with the benefit of immediate feedback alone, a second OSLER, within 48 h following the index exam, revealed an overall average gain ratio of 15% for the entire cohort. The OSLER has now been adopted by several healthcare institutions globally as an acceptable Long-Case solution for their needs. It has also been combined with the OSCE, which assesses the parts of the sum, with the OSLER assessing the sum of the parts.
Indexed as
Identifiers
42678504What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.