Assessing tutorial-based assessment.
Since the development of problem-based learning curricula, medical educators have viewed tutorials as an ideal context within which medical student competence can be assessed. Advantages of tutorial-based assessment include, (a) evaluation based on prolonged and intense interactions between students, peers, and tutors, (b) the opportunity to assess domains of competence that are not readily assessed by more traditional examinations (e.g., communication skills, scientific curiosity, and respect for peers), and (c) avoidance of the negative impact of more formal summative evaluations. However, in addition to psychometric weaknesses inherent in this form of evaluation, the interpersonal relationships that serve as one of the primary strengths of the tutorial have also proven to be one of the main defects in tutorial-based assessment. The current paper will review the evidence relevant to this assessment paradox, paying particular attention to the use of self-assessment.