ABSTRACT
A starting point in the development of an assessment method is a careful consideration of exactly what one wishes to assess. I am not an advocate of detailed behavioural objectives as a precursor to any exercise in assessment; such an approach is the antithesis of problem-based, self-directed learning. But at a philosophical level, it is worth pausing to ask whether we expect the graduate of a problem-based school to be different from or better than a graduate from a ‘traditional’ school. 1 Unless one takes the outrageous position that teachers at the ‘other’ schools are deliberately intent on producing ill-equipped, outmoded, passive-aggressive physicians, a plausible starting point must be that the graduates of problem-based and other schools are more similar than different. Indeed, the literature suggests just this (Vernon and Blake, 1993); graduates of problem-based schools appear to have a comparable or slightly inferior knowledge base, similar level of skills in other areas, and are primarily identifiable by a less jaundiced view of their undergraduate experience. It may be argued that the lack of difference simply reflects the inadequacy of our measures, and we certainly do not have an overabundance of good measures of, for example, community orientation or self-directed learning. Still, we should reflect that our first responsibility to society is to demonstrate with conviction that our graduates are no worse than others in those areas central to clinical competence, and hopefully better than others in areas, such as self-directed learning or group skills, which are embraced by PBL schools.
