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History and practice of competency-based assessment
1Office of Curriculum and Assessment, Faculty of Family Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York 14620, USA. stephen_lurie@urmc.rochester.edu
Medical Education
|December 14, 2011
Summary
Competency-based medical education lacks dependable assessment tools because models are legislated, not data-driven. Future efforts require data-based hypotheses, situational specificity, and resource metrics for accurate clinical behavior measurement.
Area of Science:
- Medical Education Research
- Competency-Based Assessment
- Clinical Behavioral Science
Background:
- Medical education increasingly focuses on global competencies, driven by evolving professional expectations.
- Despite decades of study, competency-based education has not yielded reliable assessment tools.
- Current competency frameworks often use prescriptive language rather than descriptive, data-driven approaches.
Observation:
- Competency models are frequently legislated, not empirically derived from observed behaviors.
- Existing assessment tools struggle to reliably measure actual clinical behaviors.
- There's a disconnect between political negotiation of educational objectives and scientific validation of performance.
Findings:
- Effective measurement of clinical behaviors requires framing educational constructs as data-based hypotheses.
- Competency constructs must be specified by relevant situations, not as global personal traits.
- Rigorous establishment of resource metrics is crucial for rational selection of assessment methods.
Implications:
- Shifting from legislated models to empirically grounded ones can improve clinical behavior assessment.
- Clearer conceptualization and situational specificity will enhance the validity of competency measures.
- Developing standardized resource metrics will enable more objective and comparable assessment across different methods.
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