• Junaid Sarfraz Khan


Assessment has been shown to drive learning. For assessment to drive learning in the right direction,it needs to fulfil certain criteria including reliability, validity, educational impact, feasibility,acceptability to stakeholders, cost-effectiveness etc. Assessment has the greatest effect as a drivingforce in learning if it is authentic, context relevant and samples widely. In this paper, we present anew curriculum design and a model for experiential learning through assessment. We call itAssessment Directed Medical Education (ADME) Curriculum using Assessment Driven IntegratedLearning (ADIL). In this model, we propose a cent percent rightest shift in the curriculum design andlearning strategy by using assessment as the sole tool to a self-directed learning process throughsupervised simulated and real-patient encounters testing competencies in cognitive, psychomotor andaffective domains in an integrated approach utilising key resources for active learning. It is presumedthat, this will, in the long term improve health care delivery by producing competent healthcareprofessionals that have learned through direct student-‘patient’ encounters from day one of theirmedical education and are competent in making professional judgments, exhibit appropriate skillsand behaviours.Keywords: Assessment, Learning technique, CME, Curriculum, Evaluation, Competency based


Van der Vleuten CPM. The assessment of professional

competence: developments, research and practical implications.

Adv Health Sci Educ 1996;1(1):41–67.

Gibbs G, Simpson C. How Assessment Influences Student

Learning – a Conceptual Overview. Centre for Higher Educ Prac;

McLachlan JC. The relationship between assessment and learning.

Med Educ 2006;40:716–7.

Roediger HL, Karpicke JD. Test-enhanced learning: taking

memory tests improves longterm retention. Psychol Sci


Woollard M, Whitfield R, Newcombe RG, Colquhoun M, Vetter

N, Chamberlain D. Optimal refresher training intervals for AED

and CPR skills: a randomized controlled trial. Resuscitation


J Ayub Med Coll Abbottabad 2010;22(4)

Wheeler MA, Ewers M, Buonanno JF. Different rates of

forgetting following study versus test trials. Memory


Downing SM. The metric of medical education. Validity: on the

meaningful interpretation of assessment data. Med Educ


Arthur W Jr. Factors that influence skill decay and retention: a

quantitative review and analysis. Hum Perform 1998;11:57–102.

Bloom BS. Taxonomy of educational objectives, Handbook 1:

The cognitive domain. New York. David McKay Co Inc. 1956.

Druckman D, Bjork RA. Optimising longterm retention and

transfer. In the Mind’s Eye: Enhancing Human Perform. National

Academy Press; 1991. p. 23–56.

Berden H, Willems F, Hendrick J, Knape J. How frequently

should basic cardiopulmonary resuscitation training be repeated to

maintain adequate skills? BMJ 1993;306:1576–7.

Kuo TM, Hirshman E. Investigations of the testing effect. Am J

Psychol 1996;109:451–64.

Karpicke JD, Roediger HL. Repeated retrieval during learning is

the key to enhancing later retention. J Mem Lang 2007;57:151–62.

Carpenter SK, DeLosh EL. Impoverished cue support enhances

subsequent retention: support for the elaborative retrieval

explanation of the testing effect. Mem Cognit 2006;34:268–76.

van der Vleuten CPM, Schuwirth WT, Lambert. Assessing

professional competence: from methods to programmes. Med

Educ 2005;39:309–17.

Swanson DB, Norman GR, Linn RL. Performance-based

assessment: lessons from the health professions. Educ Res


Norcini JJ, Swanson DB, Grosso LJ, Webster GD. Reliability

validity and efficiency of multiple choice question and patient

management problem item formats in assessment of clinical

competence. Med Educ 1985;19:238–47.

Rethans JJ, Norcini JJ, Baron-Maldonado M, Blackmore D, Jolly

BC, LaDuca T, et al. The relationship between competence and

performance: implications for assessing practice performance.

Med Educ. 1985;36(10): 901–9.

Smith SR, Dollase RH, Boss JA. Assessing students’ performance

in a competency-based curriculum. Acad Med 2003;78:97–107.

Williams, RG, Klamen DA, McGaghie WC. Cognitive, social and

environmental sources of bias in clinical performance ratings.

Teach Learn Med 2003;15:270–92.

Miller GE. The assessment of clinical skills⁄competence⁄

performance. Acad Med 1990;65(9):63–7.

van der Vleuten CPM, Norman GR, de Graaff E. Pitfalls in the

pursuit of objectivity: issues of reliability. Med Educ


Epstein RM. Comprehensive Assessment Manual. New York:

Rochester; 2001.

Crossley J, Humphris G, Jolly B. Assessing health professionals.

Med Educ 2002;36:800–4.

Epstein RM, Hundert EM. Defining and assessing professional

competence. JAMA 2002;287:226–35.

Turnbull J, van Barneveld C. Assessment of clinical performance:

In-training evaluation. In: Norman GR, van der Vleuten CPM,

Newble DI, eds. International Handbook of Research in Medical

Education. Dordrecht, Netherlands: Kluwer Academic Publishers;

p. 793–810.

Issenberg SB, McGaghie WC, Petrusa ER, Gordon DL, Scalese

RJ. Features and uses of high-fidelity medical simulations that

lead to effective learning: a BEME systematic review. Med Teach


Rosenbaum DA, Carlson RA, Gilmore RO. Acquisition of

intellectual and perceptual motor skills. Annu Rev Psychol


Wass V, Jones R, van der Vleuten C. Standardized or real patients

to test clinical competence? The long case revisited. Med Educ


Bangert-Drowns RL, Kulik J. Effects of frequent classroom

testing. J Educ Res 1991;85(2):89–99.

Kromann BC, Jensen ML, Ringsted C. The effect of testing on

skills learning. Med Educ 2009;43:21–7.

Schoonheim-Klein ME, Habets L, Aartman IHA, van der Vleuten

CP, Hoogstraten J, van der Velden, U. Implementing an objective

structured clinical examination (OSCE) in dental education:

effects on students’ learning strategies. Eur J Dent Educ


Coles C. Developing professional judgment. J Contin Educ Health

Prof. 2002;22(1):3–10.

Issenberg SB, McGaghie WC, Hart IR, et al. Simulation

technology for health care professional skills training and

assessment. JAMA 1999;282:861–6.

Roediger HL, Karpicke JD. The power of testing memory: basic

research and implications for educational practice. Perspect

Psychol Sci 2006;1:181–276.



Most read articles by the same author(s)

1 2 > >>