Editor's note: As part of our 50th volume celebrations, Medical Education is looking back at its most impactful articles, as defined by citation count. The most cited articles from each 5-year interval were identified and the original authors of one of them (or other knowledgeable scholars if the original authors could not be found) were asked to comment on the state of the field at the time of the publication, the impact of the article, and what we have learned since then. The article illustrated in Figure 1 was one of the most cited articles in our journal in the 2002-2006 period. To see the other top-cited articles from Volumes 1–50 please view the interactive PDF by visiting www.mededuc.com. The 2005 paper to which the title of this piece refers represented a landmark in my thinking around assessment. 1 It started, however, with an earlier paper published in 1996, which has also been cited frequently. 2 The earlier paper identi-fied five distinct quality characteristics of any assessment method: reliability; validity; educational impact; acceptability, and costs. 2 Although these five criteria have been used frequently in research on assessment, this was not the main message of the paper. 2 Many other quality characteristics are possible and are also mentioned in the litera-ture. 3,4 The central tenet of the paper 2 was that any single assessment method can never be per-fect on all criteria and in reality assessment always involves a compromise. Good assessment involves a mindful choice about where and how to com-promise. The nature of the compromise will depend on the purpose of the assessment and the assessment context. For example, the compromises made in relation to a certification examination will differ from those required in an in-training assessment. Any single assessment method can never be perfect on all criteria and in reality assessment always involves a compromise.
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