Send to

Choose Destination
Acad Med. 2018 Mar;93(3S Competency-Based, Time-Variable Education in the Health Professions):S17-S21. doi: 10.1097/ACM.0000000000002066.

Enhanced Requirements for Assessment in a Competency-Based, Time-Variable Medical Education System.

Author information

L.D. Gruppen is professor, Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, Michigan. O. ten Cate is professor of medical education, Center for Research and Development of Education, University Medical Center Utrecht, Utrecht, the Netherlands. L.A. Lingard is professor, Department of Medicine, and director, Centre for Education Research & Innovation, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada. P.W. Teunissen is professor, School of Health Professions Education, Maastricht University, Maastricht, the Netherlands, and maternal fetal medicine specialist, VU University Medical Center, Amsterdam, the Netherlands. J.R. Kogan is professor of medicine, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.


Competency-based, time-variable medical education has reshaped the perceptions and practices of teachers, curriculum designers, faculty developers, clinician educators, and program administrators. This increasingly popular approach highlights the fact that learning among different individuals varies in duration, foundation, and goal. Time variability places particular demands on the assessment data that are so necessary for making decisions about learner progress. These decisions may be formative (e.g., feedback for improvement) or summative (e.g., decisions about advancing a student). This article identifies challenges to collecting assessment data and to making assessment decisions in a time-variable system. These challenges include managing assessment data, defining and making valid assessment decisions, innovating in assessment, and modeling the considerable complexity of assessment in real-world settings and richly interconnected social systems. There are hopeful signs of creativity in assessment both from researchers and practitioners, but the transition from a traditional to a competency-based medical education system will likely continue to create much controversy and offer opportunities for originality and innovation in assessment.

Supplemental Content

Full text links

Icon for Wolters Kluwer
Loading ...
Support Center