Ipsative Assessment: Concept and Assimilation in Competency-based Assessment in Undergraduate Medical Training

Traditionally, competency-based assessment is a criterion-referenced assessment that should be continuous and frequent, with ample feedback opportunities. In this criterion-referenced assessment, the progress of a student is measured against a "set standard reference." As the objective of a competency-based medical curriculum (CBMC) is the acquisition of competencies by the learners, evidence must be available to "chart the learning curve" of the trainee during a training period. This evidence can be generated by ipsative assessments, which are sequentially conducted assessments in which the performance of a trainee in an assessment test is compared with his/her previous assessment test. These ipsative assessments provide opportunities to track the educational development of any individual trainee and help in self-assessment. Given the enormous potential of ipsative assessment in the individualized, longitudinal, and educational development of medical undergraduates and given that competency-based medical curricula and ipsative assessment are complementary to each other in many ways, it has been suggested that ipsative assessment must be a part of medical training programs. In this article, we provide a conceptual framework for incorporating ipsative assessment activities into the undergraduate CBMC.