LAUSR

The concept of programmatic assessment in health professions education was introduced in 2005 [1] and is rapidly gaining traction. Its central tenet is appealing: assessing learners longitudinally with a variety of methods that are embedded in the educational process, and that afford both assessment of learning and assessment for learning. Programmatic assessment accommodates both low-stake and high-stake decisions and is reminiscent of what a vocal coach does: he helps to make a singer achieve his or her utmost potential (by giving frequent feedback) but eventually will make a summative decision whether the singer can join the choir or can be the soloist. While some aspects of programmatic assessment extend existing assessment practices, others are quite new. For instance, continuous and longitudinal assessment, which is part of programmatic assessment, is not new; progress testing was introduced in the 1970s and applies the principle of repeated assessments in the knowledge domain with multiple-choice tests. Also, the combined use of multiple assessment formats is not new. In workplace-based assessment, for example, combining direct observation and 360-degree feedback, as well as the use of portfolios, have been around for much longer. Three aspects, however, are quite unique and fundamental to programmatic assessment: (1) meaningful triangulation across instruments; (2) proportionality of decision making; and (3) diversity of quality assurance processes.