Assessing Clinico-Social Case Discussions Among Undergraduate Medical Students: A Comparative Study of Structured and Conventional Methods

Background: Clinico-social case discussions are an important component of undergraduate Community Medicine practical assessment, evaluating students' ability to integrate clinical findings with social determinants, epidemiological reasoning, and preventive strategies.Conventional assessment methods allow holistic evaluation but may be affected by variability in examiner judgement.Structured assessment tools may improve clarity and consistency while preserving the comprehensive nature of case discussions.Objectives: To compare the scoring patterns and inter-rater reliability of a structured assessment tool with the conventional method for clinico-social case discussions among Phase III MBBS students; and to describe faculty feedback regarding the feasibility and usefulness of the structured assessment approach.Methods: A comparative observational study was conducted among 78 Phase III MBBS students posted in Community Medicine.A structured assessment tool with criterion-based domains and predefined scoring allocations was compared with the conventional assessment method.Thirty-two students were assessed simultaneously using conventional and structured methods to compare scoring patterns.Forty-six students were assessed by two examiners using the same method to determine inter-rater reliability.A supplementary descriptive component documented faculty feedback regarding the feasibility and usefulness of structured assessment using an open-ended questionnaire.Responses were summarized descriptively.Results: Structured assessment scores were significantly lower than conventional scores (mean difference 1.31, p<0.001), with moderate correlation between methods (r=0.605).Both methods demonstrated good inter-rater reliability, with intraclass correlation coefficients (ICCs) of 0.782 and 0.826 for conventional and structured assessment, respectively.Faculty feedback highlighted the potential of structured assessment to improve clarity and standardization, while emphasizing the need to retain flexibility.Conclusion: Structured assessment can provide a useful framework for clinico-social case discussions by improving transparency and guiding examiner judgement.Effective implementation requires balancing structured criteria with flexibility, along with examiner training.