Three key issues for determining competence in a system of assessment

Abstract

There is widespread agreement that medical education should include multi-source, multi-method, and multi-purpose forms of assessment and thus should move towards cohesive systems of assessment. One possibility that fits comfortably with a system of assessment framework is to organize assessments around a competency based medical education model. However conceptually appealing a competency based medical education model is, discussions are sparse regarding the details of determining competence (or the pass/fail point) within each competency. In an effort to make discussions more concrete, we put forth three key issues relevant to implementation of competency-based assessment: (1) each competency is measured with multiple assessments, (2) not all assessments produce a score for a competency as a good portion of assessment in medical school is narrative, and (3) competence decisions re-occur as assessments cumulate. We agree there are a host of other issues to consider, but think the practical action-oriented issues we set forth will be helpful in putting form into what is now largely abstract discussions.

Keywords:

• Standard setting
• undergraduate
• outcome-based

Acknowledgments

Previous portions of this paper were presented at the 2019 Generalists in Medical Education Meeting, Phoenix, AZ.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Additional information

Notes on contributors

Jorie M. Colbert-Getz

Jorie M. Colbert-Getz, PhD, is Assistant Dean of Education Quality Improvement and Associate Professor, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah.

Judy A. Shea

Judy A. Shea, PhD, is Professor of Medicine–clinician educator and Associate Dean of Assessment and Medical Education Research, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.