Assessment during postgraduate training

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Abstract
The author reviews the traditional process of assessing both undergraduates in medical school and physicians in postgraduate training, contending that this traditional, and still dominant, process is inadequate because of its limitations. It focuses narrowly on end-point evaluation, using predominantly multiple-choice questions, rather than on identifying deficiencies during the training period so that trainees are able to correct these deficiencies before their end-point evaluations. An example of a more valid process of assessment is the set of tests employed by the Royal Australian College of General Practitioners to assess the skills of family practice physicians, by using behavioral ratings. The author concludes that where such tests are used, there may be some difficulty in comparing the performances of undergraduates with those of practicing physicians, in view of the different behaviors being assessed. In any follow-up studies of graduates, attention should be paid to the reliability and validity of the assessment procedures, particularly because differences in the assessment tools may account for some discrepancies between training programs.

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