Performance-Based Assessment: Lessons From the Health Professions

Performance-based assessment methods have been used in the health professions for centuries, and dozens of studies of their psychometric characteristics have been reported over the past several decades. During that period, the health professions have seen a variety of performance-based assessment methods come and go, and some hard lessons have been learned from the many studies and frequent missteps. This article shares some of those lessons, using four performance-based assessment methods as examples: written clinical simulations (more commonly termed patient management problems), computer-based clinical simulations, oral examinations, and standardized patients (“live” simulations).