Examinations should be motivating, inspiring and interesting for stude
nts and evaluation should be an essential pan of learning. The evaluat
ion is optimal when it is as practical and patient related as possible
, To meet these criteria, we have developed examinations that are prac
tice related by using case problem as questions in written examination
and by presenting case problems with slides as an examination. Our ai
m has been to teach students to seek out knowledge from the literature
by allowing the use of a textbook in solving problem cases in the exa
mination. In order to teach consultation skills in some case problems,
students have to write a referral. Furthermore, feedback on the exami
nations has developed to teach consultation skills by using peer evalu
ation and peer learning in the feedback. According to principles of ob
jective structured clinical examination, we have developed an exam whe
re the students are evaluated when they are examining real patients in
a pediatric ward. The assessment of clinical skills is performed duri
ng the patient examination by using a structured evaluation form, and
also during personal discussion with the student after the examination
. Since the feedback from our students has been encouraging we describ
e our evaluation scheme in detail.