Defining and assessing competence

Abstract

The ability to conduct effective clinical skills remediation has been greatly enhanced by an emerging consensus on the definition of medical competence and the consequent development of information-rich strategies to assess competence. In this chapter the authors describe how the definition of medical competence has evolved from a vague, intuitive impression toward a more analytic articulation of areas of competence with welldefined expectations within each area. They describe debates and present key concepts that greatly influence the practice of remediation in medical education such as entrustment, expertise development, deliberate practice, learning curves, and assessment for learning. Finally they describe an example under development of assessment for learning.