Review of CRADLE Seminar Series #7: Programmatic assessment: hype or necessary development? By Susie Macfarlane

1 September 2022

Susie MacFarlane is the Associate Director, Learning Innovation (Health), Deakin University and a CRADLE PhD student. Here she reviews Professor Lambert Schuwirth’s discussion on programmatic assessment and its attempt to optimise its learning function through meaningful feedback and reflection at different stages of assessment.

In his presentation, Professor Lambert Schuwirth outlines the past and current state of programmatic assessment in medical education, and the limitations of traditional assessment in verifying students’ competence in complex capabilities. In the 1990’s, assessment drew on psychological testing and the goal therefore was to validly and reliably measure traits assumed to be stable and independent of each other. Summing scores from different tests or their components is reductive, according to Professor Schuwirth who highlighted the loss of rich information about students’ performance. When single scores from different assessments are combined to reconstitute student’s competence, there is not enough information to know what the student can do or the areas they need to develop.

Despite the well-established limitations of each type of assessment, in traditional assessment, high-stakes decisions about students’ progression are made with each task or unit of study. Professor Schuwirth identifies that traditional assessment designs across the programme do not support students’ development over time, and opportunities for feedback, reflection and mitigation of learning gaps are rarely provided.

Professor Schuwirth then outlined Programmatic Assessment principles, within the context of medical education. This approach features holistic, continual and longitudinal assessment with multiple assessment instruments. Information from multiple sources including performance on assessment tasks, feedback, supervisors’ and students’ own reflections is combined to form meaningful pictures of students’ development and competence. High stakes decisions about a students’ readiness to progress or graduate need rich information from a range of sources to be combined and considered together. Assessment scores are formative, informing actionable learning goals. Knowledge, skills, attitudes and behaviours are not assessed independently; competence is complex, holistic and integrated, unable to be pulled apart and measured discretely.

Professor Schuwirth’s presentation highlighted for me the humanity of programmatic assessment: not measuring milestones, but rigorously designing for and coaching students’ progression on their learning journey.

Don’t forget, CRADLE Seminar Series #8: ‘Hyper-hybrid Learning Spaces’ with Rikke Toft Nørgård of Aarhus University will be held on Tuesday 6 September 2022 at 5pm (AEST). Be part of the event by registering here!

Further Reading & Resources

• King, S. M., Schuwirth, L. W., & Jordaan, J. H. (2022). Embedding a Coaching Culture into Programmatic Assessment. Education Sciences, 12(4), 273. https://doi.org/10.3390/educsci12040273
• Torre, D., Schuwirth, L., Van der Vleuten, C., & Heeneman, S. (2022). An international study on the implementation of programmatic assessment: Understanding challenges and exploring solutions. Medical Teacher, 1-10. https://doi.org/10.1080/0142159X.2022.2083487
• Heeneman, S., de Jong, L. H., Dawson, L. J., Wilkinson, T. J., Ryan, A., Tait, G. R., Rice, N, Torre, D, Freeman, A & van der Vleuten, C. P. (2021). Ottawa 2020 consensus statement for programmatic assessment–1. Agreement on the principles. Medical Teacher, 43(10), 1139-1148. https://doi.org/10.1080/0142159X.2021.1957088
• Pearce, J., & Tavares, W. (2021). A philosophical history of programmatic assessment: Tracing shifting configurations. Advances in Health Sciences Education, 26(4), 1291-1310. https://doi.org/10.1007/s10459-021-10050-1
• Schuwirth, L. W., & Van Der Vleuten, C. P. (2019). Current assessment in medical education: Programmatic assessment. Journal of Applied Testing Technology, 20(S2), 2-10. http://www.jattjournal.com/index.php/atp/article/view/143673
• Schuwirth, L. W., & Van der Vleuten, C. P. (2011). Programmatic assessment: from assessment of learning to assessment for learning. Medical teacher, 33(6), 478-485. https://doi.org/10.3109/0142159X.2011.565828