Introduction

Introduction

Regardless of the type of curriculum in place in any medical school, the issue of assessment is never far from the thoughts of both students and staff. Assessment performs many functions in undergraduate medical training. To paraphrase Osler it should not signify the end of learning or education but rather be an accessory in their acquisition. All too often, particularly from the medical students’ point of view, the successful completion of an assessment means that they can then forget about that topic or subject and move on to the next. Outcomes-based education, with an emphasis on progression and different levels of achievement for each outcome, can break this inefficient cycle, but only if it is supported by robust, effective and appropriate assessment.

Having taken the bold step of declaring a consensus on learning outcomes for undergraduate medical education in Scotland, it was inevitable, and indeed essential, in terms of the credibility of the outcomes that we should turn our attention to assessment. Although at times it may seem that assessment has been "done to death" by educationalists, there is always room for a fresh approach particularly when a focus such as the learning outcomes is available.

As might be expected some of the answers the working groups arrived at in response to their remit reinforced the fundamental principles of "good" assessment; namely that it should be valid, reliable, fair and feasible, that it should tell us about the quality of student learning, ensure minimum standards, encourage student effort and evaluate the effectiveness of the course. Reliability and validity are the most essential pre-requisites for high quality assessment but they can only be established when the context, the task, the purpose and the instruments/tools of assessment are designed and administered. Hence the findings of the working groups in relation to validity and reliability of assessment tools when applied to the outcomes is extrapolated from what is already known about them from their use in non-outcomes based education.

Many of the findings and conclusions of the working groups reiterate much of what has been said in the past about assessment of other types of curricula. However, there are some issues which are specific to outcomes-based education and which will necessitate the adoption or development of new methods of assessment.

The process of considering how to assess the outcomes has inevitably lead to a rethinking of the way in which many of them are defined. It was agreed that none of the outcomes should be discarded at this stage on the grounds that they cannot be assessed but some may need amended.