Competency-based assessment and cultural compression in medical education: Lessons from educational anthropology

Abstract

OBJECTIVE: This paper explores the thesis that medical education is the cultural transmission to learners of specific values, which are increasingly expressed as graduation competencies. As testing is a powerful way to transmit cultural values to learners in a brief period of time, competency-based assessments can be an instrument of cultural compression in medical education. METHODS: The author reviewed medical literature to illustrate the concepts from educational anthropology, led the process one medical school used to develop its list of graduation competencies, and conducted a citation search about competency domains. RESULTS: There is support in the literature for viewing medical education as an example of cultural transmission and compression and for the assertion that testing influences student behaviour. The graduation competency statements developed by the school reflect traditional and emergent values. The citation search data confirmed that some competency domains reflected traditional values, while others reflected more emergent values. CONCLUSION: Concepts from educational anthropology are relevant to medical education and provide perspectives for understanding contemporary issues such as competency-based assessments. © Blackwell Publishing Ltd 2005.