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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.
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“Two recently implemented initiatives in medical education, competencybased medical education (CBME) [9][10][11] and programmatic assessment of learners, 12 have the potential to improve the practice of feedback by promoting frequent observation of learners, feedback conversations, and coaching for improvement.”
From The R2C2 Model in Residency Education: How Does It Foster Coaching and Promote Feedback Use? (2018) · cites this paper as [11]
In the citing paper
“Finally, they promote the longitudinal compilation of performance data to coach the learner's continuing development (assessment for learning) and to make evidence-based decisions about the learner's progress (assessment of learning).[11][12][13][14][15]”
From The R2C2 Model in Residency Education: How Does It Foster Coaching and Promote Feedback Use? (2018) · cites this paper as [11]
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“La evaluación de la competencia es un proceso complejo, que requiere múltiples pruebas y evaluadores, y metodologías válidas y fiables 8,9 .”
BackgroundFaculty- and Program-Level Adaptations to Competency-Based Assessment Demands
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Multiple-Choice Questions in Basic Biomedical Science Module
Permasutha, M. B., Rahayu, G. R., Giri, M. K. W., & Pradiptha, D. A. G. F. (2024) · Jurnal Pendidikan dan Pengajaran · doi:10.23887/jpp.v57i1.63314 · Cited by 1
“…goals: to optimize students' abilities through motivation and direction for future learning; to safeguard society through the competency assessment process for medical graduates; and to provide students with a foundation for pursuing advanced degrees (Lockyer et al., 2017; Ten Cate & Regehr, 2019).”
BackgroundSchloss, D., Estock, J. L., Ashjaei, A., Mikolic, J. M., El-Kouri, N., Elias, M. E., Lara-Gutierrez, J., Eibling, D. E., Duran, H.-T., Alfaras-Melainis, K., et al. (2024) · Simulation in Healthcare The Journal of the Society for Simulation in Healthcare · doi:10.1097/sih.0000000000000814 · Cited by 1
Gupta, P., Chaudhary, A., Priya, A., Srivastava, A., Kumar, A., & Singh, P. (2024) · Research and Development in Medical Education · doi:10.34172/rdme.33208 · Cited by 1
Facilitating Seamless Integration of Game-based Assessments in Medical Education
Shrivastava, S. R., Bobhate, P. S., Petkar, P. B., Tiwade, Y. R., & Badge, A. K. (2024) · Contemporary Clinical Dentistry · doi:10.4103/ccd.ccd_33_24 · Cited by 1
“[2] There arises the need to resort to innovative forms of assessments, which can play a defining role in the holistic development of medical students, and thereby ensure that students possess resilience, adaptability and are creative enough to deal with health‑care challenges.”
BackgroundBarak, G., Foradori, D. M., Fromme, H. B., Zuniga, L. M., & Dean, A. L. (2024) · MedEdPORTAL · doi:10.15766/mep_2374-8265.11449 · Cited by 1
Validity of the Diabetic Wound Assessment Learning Tool
Selim, O., Dueck, A. D., Kulasegaram, K. M., Brydges, R., Walsh, C. M., & Okrainec, A. (2025) · The Clinical Teacher · doi:10.1111/tct.70025 · Cited by 1
“CBME advocates often recommend that these assessments be conducted frequently to better guide trainee learning [4].”
Skelton, E., Sharpe, R., Bartlett, M. A., O’Sullivan, C., & Harrison, G. (2025) · Radiography · doi:10.1016/j.radi.2025.102998 · Cited by 1
Mgaya, S. (2023) · EAST AFRICAN JOURNAL OF MANAGEMENT AND BUSINESS STUDIES · doi:10.46606/eajmbs2023v03i03.0024 · Cited by 1
Jugement évaluatif : confrontation d’un modèle conceptuel à des données empiriques
Gauthier, G., Couture, S., & St‐Onge, C. (2018) · Pédagogie médicale · doi:10.1051/pmed/2019002 · Cited by 1
Yune, S.-J., Lee, S. Y., & Im, S. J. (2019) · Korean Medical Education Review · doi:10.17496/kmer.2019.21.1.51 · Cited by 1
“외에는 성과바탕교육 (outcome-based education)의 도입으로 다양한 성과에 따른 평가체 계를 요구하고 있다[6,7].”
Rutgers, D. R., van Schaik, J. P. J., Kruitwagen, C. L. J. J., Haaring, C., van Lankeren, W., van Raamt, A. F., & ten Cate, O. (2020) · Medical Science Educator · doi:10.1007/s40670-020-00977-2 · Cited by 1
Wu, M., Brill, D., Shirodkar, M. P., Tan, J., Poptani, M., Wang, Y., & Haworth, I. S. (2021) · International Journal of Educational Management · doi:10.1108/ijem-10-2020-0494 · Cited by 1
Jiwane, R., Jiwane, S., Tiwari, N., & Gajbhiye, V. M. (2023) · International Journal of Research in Medical Sciences · doi:10.18203/2320-6012.ijrms20232430 · Cited by 1
Shaver, S. L. (2023) · Wiley eBooks · doi:10.1002/9781119852865.ch11 · Cited by 3
Thayer, T. (2024) · BDJ · doi:10.1038/s41415-024-6768-2 · Cited by 1
Flood, M. (2018) · Lancaster EPrints (Lancaster University) · doi:10.17635/lancaster/thesis/494
Hodwitz, K. (2018) · TSpace (University of Toronto)
Maximizing Effective Feedback and End-of-Course Evaluations
Kogan, J. R. (2019) · Springer eBooks · doi:10.1007/978-3-030-31957-1_11
Barzegar, M., Ghaffari, R., Rahmani, F., Ghaffarzad, A., Zangbar, H. S., Fallahi, S., & Jafari-Rouhi, A. H. (2020) · Research and Development in Medical Education · doi:10.34172/rdme.2020.009
Surgical Education: Context and Trends
Coker, D. J. (2020) · Springer eBooks · doi:10.1007/978-981-13-6106-7_5-1
Competency-based portfolio assessment
Pool, A. O. (2020) · Research Publications (Maastricht University) · doi:10.26481/dis.20201106ao
Metadata
- Authors
- Lockyer, J., Carraccio, C., Chan, M.-K., Hart, D., Smee, S., Touchie, C., Holmboe, E. S., Frank, J. R., & Collaborators, O. B. O. T. I.
- Affiliations
- University of Calgary (CA)
- American Board of Pediatrics, Chapel Hill, NC, USA;
- University of Manitoba (CA)
- University of Minnesota (US)
- Medical Council of Canada (CA)
- Accreditation Council for Graduate Medical Education (US)
- University of Ottawa (CA)
- Corresponding author
- Lockyer, Jocelyn
- ORCID
- Venue
- Medical Teacher
- Publisher
- Informa UK Limited
- Published
- 2017-06-03
- Volume
- 39
- Issue
- 6
- Pages
- 609-616
- ISSN
- 0142-159X (ISSN-L)
- 1466-187X
- OpenAlex
- W2623879525
- Cited by
- 493
- References
- 59
- Citations by year
- 2026: 36 · 2025: 40 · 2024: 69 · 2023: 78 · 2022: 66 · 2021: 75 · 2020: 57 · 2019: 36 · 2018: 29 · 2017: 6
- FWCI
- 32.74
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Medical Teacher (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Education › Innovations in Medical Education
- Social Sciences › Education › Student Assessment and Feedback
- Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Competency Development and Evaluation
- Keywords
- competency-based medical education, learning assessment, assessment for learning, assessor training, psychometrics, feedback, assessment system improvement
- MeSH terms
- Clinical Competence, Competency-Based Education, Education, Medical, Educational Measurement, Feedback, Humans, Learning, Psychometrics
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