ABSTRACT
Competence describes what an individual is able to do in clinical practice, while performance should describe what an individual actually does in clinical practice. Clinical competence is the term being used most frequently by many of the professional regulatory bodies and in the educational literature. The assessment of clinical performance has historically involved direct observation of learners by professional colleagues. Assessment tools for clinical competence include the objective structured clinical examination, the objective structured long case examination record, and the objective structured assessment of technical skills. Developing performance assessments using simulation may be the most defensible method of ensuring reliability and validity for individual practitioners’ health care teams and organizations. There is little current research on the educational impact of direct observation of procedural skills, although the opportunity for timely feedback gives it the potential for high educational value. Acceptability may be inferred from the number of completed assessment forms.
