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Abstract
Since the 1970s, assessment of competence in the health professions has been dominated by a discourse of psychometrics that emphasizes the conversion of human behaviors to numbers and prioritizes high-stakes, point-in-time sampling, and standardization. There are many advantages to this approach, including increased fairness to test takers; however, some limitations of overemphasis on this paradigm are evident. Further, two shifts are underway that have significant consequences for assessment. First, as clinical practice becomes more interprofessional and team-based, the locus of competence is shifting from individuals to teams. Second, expensive, high-stakes final examinations are not well suited for longitudinal assessment in workplaces. The result is a need to consider assessment methods that are subjective and collective.