Key considerations in planning and designing programmatic assessment in competency-based medical education

Abstract

Programmatic assessment as a concept is still novel for many in clinical education, and there may be a disconnect between the academics who publish about programmatic assessment and the front-line clinical educators who must put theory into practice. In this paper, we clearly define programmatic assessment and present high-level guidelines about its implementation in competency-based medical education (CBME) programs. The guidelines are informed by literature and by lessons learned from established programmatic assessment approaches. We articulate five steps to consider when implementing programmatic assessment in CBME contexts: articulate the purpose of the program of assessment, determine what must be assessed, choose tools fit for purpose, consider the stakes of assessments, and define processes for interpreting assessment data. In the process, we seek to offer a helpful guide or template for front-line clinical educators. We dispel some myths about programmatic assessment to help training programs as they look to design–or redesign–programs of assessment. In particular, we highlight the notion that programmatic assessment is not ‘one size fits all’; rather, it is a system of assessment that results when shared common principles are considered and applied by individual programs as they plan and design their own bespoke model of programmatic assessment for CBME in their unique context.

Keywords:

• Assessment (general)
• assessment (clinical)
• phase of education (general)
• profession (Medicine)
• profession (General)

Disclosure statement

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

Glossary

Assessment as learning: Assessment tools or processes (low- or high-stakes) that give the learner opportunities to monitor and reflect on their own learning.

Additional information

Notes on contributors

Shelley Ross

Shelley Ross, PhD, is associate professor and director of innovation and research, CBAS Program, in the Department of Family Medicine, University of Alberta, Edmonton, Alta., and president of the Canadian Association for Medical Education.

Karen E. Hauer

Karen E. Hauer, MD, PhD, is associate dean for competency assessment and professional standards and professor of medicine at the University of California, San Francisco, California.

Keith Wycliffe-Jones

Keith Wycliffe-Jones, MBChB, FRCGP, CCFP, is associate professor in the Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta.

Andrew K. Hall

Andrew K. Hall, MD, FRCPC, MMEd, is associate professor and CBME lead in the Department of Emergency Medicine, Queen’s University, Kingston, Ont., and clinician educator at the Royal College of Physicians and Surgeons of Canada.

Laura Molgaard

Laura Molgaard, DVM, is interim dean at the University of Minnesota College of Veterinary Medicine, St. Paul, Minn.

Denyse Richardson

Denyse Richardson, MD, BScPT, MEd, is associate professor in the Division of Physiatry, Department of Medicine, University of Toronto, Toronto, Ont., and clinician educator at the Royal College of Physicians and Surgeons of Canada.

Anna Oswald

Anna Oswald, MD, FRCPC, MMEd, is professor in the Department of Medicine and CBME lead for the Faculty of Medicine & Dentistry at the University of Alberta, Edmonton, Alta., and clinician educator at the Royal College of Physicians and Surgeons of Canada.

Farhan Bhanji

Farhan Bhanji, MD, MHPE, FRCPC, is professor of Pediatrics at McGill University, Montreal, Que., and associate director, assessment, at the Royal College of Physicians and Surgeons of Canada.