How to Design a Useful Test: The Principles of Assessment

This chapter guides the reader through the field of assessment of medical competence and performance by providing background information and a few guidelines. The most important messages the authors have tried to convey are that in designing high-quality assessments, foundations are rational decisions based on the best available evidence and careful quality control. The chapter describes the major strengths and weaknesses of different groups of commonly used assessment methods, using the five criteria that include: reliability, validity, educational impact, cost-efficiency and acceptability. Objective structured clinical examinations (OSCEs) and simulated patient (SP)-based examinations have become very popular for the assessment of (practical) skills. There are some interesting and potential possibilities presented by computer-based assessment that are unique to the format and not merely logistical advantages. The authors discuss three of them here - namely, real-time simulations, sequential testing and computer-adaptive testing.