Assessment of clinical competence

Tests of clinical competence, which allow decisions to be made about medica l qualification and fitness to practise, must be designed with respect to k ey issues including blueprinting, validity, reliability, and standard setti ng, as well as clarity about their formative or summative function. Multipl e choice questions, essays, and oral examinations could be used to test fac tual recall and applied knowledge, but more sophisticated methods are neede d to assess clinical performance, including directly observed long and shor t cases, objective structured clinical examinations, and the use of standar dised patients, The goal of assessment in medical education remains the dev elopment of reliable measurements of student performance which, as well as having predictive value for subsequent clinical competence, also have a for mative, educational role.