Outline of:
Habitual and judicious use of communication, knowledge, technical skills, clinical reasoning, emotions, values, and reflection in daily practice for the benefit of the individuals and communities being served - Epstein and Hundert
may vary between situations
through deliberate practice and reflection on experience
rules-->judgements-->pattern recognition/heuristics
susceptible to stress/bias - especially for more novice
provide motivation and direction
identify incompetence
selection for further training
guiding future learning
providing reassurance
promoting reflection
shaping values
judgment of competence
judgment of fitness for practice
qualification for advancement
Appropriate methods of assessment should vary depending on goals and types of assessment
(from Van der Vleuten)
reliability (accurate and reproducible)
validity (does it measure what it purports to)
impact on future learning/practice
acceptability to learners and faculty
cost (trainee, institution, society)
Written examination
Assessment by Supervising Clinicians
Direct observation (incl video)
Clinical Simulation
multi-source assessment
portfolio
teamwork
professionalism
integrating multiple methods over time - few standards for how to do this
across institutions
assessment drives learning
unintended consequences
psychometrics often aren't good enough to elicit expert performance under varying conditions
does our testing ensure quality?
Provide direction and motivation for future learning, including knowledge, skills, and professionalism
Protect the public by upholding high professional standards and screening out trainees and physicians who are incompetent
Meet public expectations of self-regulation
Choose among applicants for advanced training
Habits of mind and behavior
Acquisition and application of knowledge and skills
Communication
Professionalism
Clinical reasoning and judgment in uncertain situations
Teamwork
Practice-based learning and improvement
Systems-based practice
Use multiple methods and a variety of environments and contexts to capture different aspects of performance
Organize assessments into repeated, ongoing, contextual, and developmental programs
Balance the use of complex, ambiguous real-life situations requiring reasoning and judgment with structured, simplified, and focused assessments of knowledge, skills, and behavior
Include directly observed behavior
Use experts to test expert judgment
Use pass–fail standards that reflect appropriate developmental levels
Provide timely feedback and mentoring
Be aware of the unintended effects of testing
Avoid punishing expert physicians who use shortcuts
Do not assume that quantitative data are more reliable, valid, or useful than qualitative data