Three key issues for determining competence in a system of assessment

Area of Science:

• Medical Education
• Assessment Science

Background:

• Medical education reform emphasizes cohesive assessment systems.
• Competency-based medical education (CBME) is a proposed framework.
• Details on determining competence within CBME are underdeveloped.

Purpose of the Study:

• To concretize discussions on implementing competency-based assessment.
• To identify practical issues in determining competence within CBME.
• To guide the development of robust assessment systems in medical schools.

Main Methods:

• Focus on three key implementation issues for competency-based assessment.
• Highlighting the need for multiple assessments per competency.
• Acknowledging the role of narrative assessments alongside scored ones.
• Emphasizing the cumulative nature of competence decisions.

Main Results:

• Competency-based assessment necessitates multiple evaluation points per competency.
• A significant portion of medical school assessment is narrative, not solely scored.
• Competence is determined through recurring decisions as assessments accumulate.

Conclusions:

• Practical implementation of competency-based assessment requires addressing specific issues.
• Integrating diverse assessment methods, including narrative feedback, is crucial.
• A system of recurring, cumulative decisions is essential for accurate competence determination.