Daring to be fallible: Reflections on culture, context and validity in programmatic assessment

Central to its developmental purpose is feedback, and effective feedback is itself deeply relational.10 The challenge for PA therefore is not just designing better assessments or accumulating better evidence but attending to the environment and the culture through which students dare to show authentic behaviour and building the trustworthy relationships that allow evidence to acquire meaning.Validity, implementation and sustainability are not identical concerns, but they intersect through assessment culture and context.Understanding those intersections may help ensure that PA remains not only a defensible system for making judgements about clinical reasoning but also a system capable of fulfilling its foundational promise of assessment for learning.