| Women 400m Medley Swimming III World Championship 1978 West Berlin - Wednesday, 23rd August - Gold Medal: Tracy Caulkins, United States | 
| Final |   | time |   | gap | L | ag | 100m | 200m | 300m |  | 1. Tracy Caulkins |   United States | 4:40.83 | WR |   | 4 | 15 | 1:03.74 | 2:15.40 | 3:37.39 |  | 2. Ulrike Tauber |   East Germany | 4:47.52 |   | +6.69s | 5 | 20 | 1:04.40 | 2:16.18 | 3:40.38 |  | 3. Petra Schneider |   East Germany | 4:48.56 |   | +7.73s | 3 | 15 | 1:03.87 | 2:18.49 | 3:43.12 |  | 4. Olga Klevakina |   Soviet Union | 4:49.16 | NR | +8.33s | 7 | 16 | 1:06.64 | 2:20.42 | 3:46.00 |  | 5. Nancy Hogshead |   United States | 4:51.49 |   | +10.66s | 6 | 16 | 1:02.92 | 2:17.93 | 3:47.67 |  | 6. Sharron Davies |   Great Britain | 4:54.78 |   | +13.95s | 1 | 15 | 1:07.24 | 2:22.46 | 3:49.65 |  | 7. Anne-Sofie Ross |   Sweden | 4:55.10 | NR | +14.27s | 2 | 18 | 1:08.23 | 2:26.39 | 3:49.28 |  | 8. Becky Smith |   Canada | 5:01.43 |   | +20.60s | 8 | 19 | 1:06.83 | 2:22.64 | 3:52.77 |   
 | 
 |  
| World Record: Ulrike Tauber, East Germany 4:42.77 (1:03.74, 2:15.29, 3:38.00) |  | Championship Record: Ulrike Tauber, East Germany 4:52.76 (1:06.00, 2:20.24, 3:44.83) 1975 |   
|
 Heats - Wednesday, 23rd August |  | Best 8 times advanced to Final>.  |   
| Heat 3 |   | time |   | gap | L | ag | Rk |  | 1. Tracy Caulkins |   United States | 4:47.08 | CR |   | - | 15 | 1. |  | 5. Anne-Sofie Ross |   Sweden | 4:56.76 |   | +9.68s | - | 18 | 2. |  | 8. Becky Smith |   Canada | 5:00.02 |   | +12.94s | - | 19 | 3. |   
| Heat 2 |   | time |   | gap | L | ag | Rk |  | 4. Nancy Hogshead |   United States | 4:56.22 |   | +9.14s | - | 16 | 2. |  | 7. Sharron Davies |   Great Britain | 4:58.91 |   | +11.83s | - | 15 | 2. |   
| Heat 1 |   | time |   | gap | L | ag | Rk |  | 3. Petra Schneider |   East Germany | 4:52.55 |   | +5.47s | - | 15 | 1. |  | 11.Flavia Nadalutti |   Brazil | 5:02.85 | NR | +15.77s | - | 17 | 2. |   
 | 
 |  
 | 
 | 
 | 
| Heat - |   | time |   | gap | L | ag | Rk  |  | 12.Carine Verbauwen |   Belgium | 5:08.12 |   | +21.04s | - | 16 |   |  | 13.Marta Slonina |   Poland | 5:09.18 | NR | +22.10s | - | _ |   |  | 14.Sonya Dangalakova |   Bulgaria | 5:09.68 |   | +22.60s | - | 15 |   |  | 15.Glenda Robertson |   Australia | 5:10.28 |   | +23.20s | - | 17 |   |  | 16.Nelly Saque |   France | 5:10.32 |   | +23.24s | - | _ |   |  | 17.Marita Karlsen |   Norway | 5:12.43 |   | +25.35s | - | 21 |   |  | 18.Colette Crabbe |   Belgium | 5:12.99 |   | +25.91s | - | 21 |   |  | 19.Lena Norboge |   Denmark | 5:15.07 |   | +27.99s | - | _ |   |  | 20.Yue-Yun Hsu |   Taiwan | 5:18.74 |   | +31.66s | - | 20 |   |  | -. Karen Van De Graaf |   Australia | DNS |   | - | - | 15 |   |  | -. Cheryl Gibson |   Canada | DNS |   | - | - | 19 |   |  | -. Maarit Vahasaari |   Finland | - |   | - | - | - |   |  | -. Moira Houston |   Great Britain | DNS |   | - | - | _ |   |  | -. Elke Holtz |   Mexico | DNS |   | - | - | _ |   |   
 | 
 |