Summative assessment of medical students in the affective domain

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Abstract
A growing awareness of the importance of professional attitudes in medicine has lead to increased attention in medical schools to medical students' communication skills and attitudes. Assessment of attitudes has always been less important than assessment of knowledge, cognitive skills and psychomotor skills. This may partly be due to the conviction of medical educators ("who are we to assess attitudes of students with summative consequences?") and partly to the lack of reliable and valid assessment instruments. A discussion of the introduction of such assessment, against the background of growing interest in the Netherlands for procedures to seriously value attitudes in patient care, is presented. The University of Amsterdam approach illustrates the possibilities of assessment of attitude and communication. Students who repeatedly do not meet the objectives in the affective domain may have to leave medical school.

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