Core principles of assessment in competency-based medical education

Abstract

The meaningful assessment of competence is critical for the implementation of effective competency-based medical education (CBME). Timely ongoing assessments are needed along with comprehensive periodic reviews to ensure that trainees continue to progress. New approaches are needed to optimize the use of multiple assessors and assessments; to synthesize the data collected from multiple assessors and multiple types of assessments; to develop faculty competence in assessment; and to ensure that relationships between the givers and receivers of feedback are appropriate. This paper describes the core principles of assessment for learning and assessment of learning. It addresses several ways to ensure the effectiveness of assessment programs, including using the right combination of assessment methods and conducting careful assessor selection and training. It provides a reconceptualization of the role of psychometrics and articulates the importance of a group process in determining trainees’ progress. In addition, it notes that, to reach its potential as a driver in trainee development, quality care, and patient safety, CBME requires effective information management and documentation as well as ongoing consideration of ways to improve the assessment system.

Disclosure statement

Eric Holmboe is employed by the ACGME and receives royalties for a textbook on assessment from Mosby-Elsevier. Resources and secretariat support for this project was provided by the Royal College of Physicians and Surgeons of Canada.

Notes on contributors

Jocelyn Lockyer, PhD, is the Senior Associate Dean of Education, and Professor, Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada.

Carol Carraccio, MD, is the Vice President, Competency-Based Assessment, American Board of Pediatrics, USA.

Ming-ka Chan, MD, is an Associate Professor at Department of Pediatrics and Child Health, University of Manitoba, Canada.

Danielle Hart, MD, is the Program Director, Emergency Medicine Residency, Director of Simulation, Interdisciplinary Simulation and Education Center, Hennepin County Medical Center, and Assistant Professor, Department of Emergency Medicine, University of Minnesota Medical School, USA.

Sydney Smee, PhD, is the Assessment Advisor for the Evaluation Bureau of the Medical Council of Canada, Ottawa, Canada.

Claire Touchie, MD, is the Chief Medical Education Advisor, Medical Council of Canada, and Associate Professor of Medicine, University of Ottawa, Canada.

Eric S. Holmboe, MD, is the Senior Vice President for Milestone Development and Evaluation, Accreditation Council for Graduate Medical Education, USA.

Jason R. Frank, MD, is the Director, Specialty Education, Strategy and Standards in the Office of Specialty Education at the Royal College of Physicians and Surgeons of Canada, and the Director of Educational Research & Development in the Department of Emergency Medicine, University of Ottawa, Canada.