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Twelve tips on how successfully fail at implementing Programmatic Assessment for Learning
Dario Torre1, Jennifer Anne Cleland2,3, Lambert Schuwirth4
1Medical Education, University of Turin School of Medicine, Turin, Italy.
Abstract:
Programmatic Assessment for Learning (PAL) has emerged as the conceptual evolution of programmatic assessment by explicitly positioning learning as the organizing principle of assessment design. Although its theoretical foundations are well established and international consensus statements have provided implementation guidance, many institutions continue to encounter substantial challenges when introducing PAL. These challenges often arise not from shortcomings of individual assessment methods, but from misalignment across curriculum, assessment, organizational culture, governance, leadership, and educational practices. This article adopts a deliberately ironic 'reverse-tips' approach to identify twelve common practices that inadvertently undermine successful implementation of PAL. Rather than presenting recommendations for what to do, each tip illustrates what organizations should avoid. In doing so, we expose the assumptions, structures, and organizational mechanisms that divert programs from the educational principles underpinning PAL. The tips emphasize that successful implementation depends on integrating assessment with curriculum design, longitudinal coaching, learner agency, meaningful interpretation of evidence, governance, faculty development, and intentional organizational culture change, while recognizing the tensions inherent in balancing learning with accountability. Collectively, these twelve (reverse) tips provide educators with a practical framework for recognizing implementation traps and critically examining whether their assessment systems remain aligned with the educational purposes of PAL.
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