Portfolio’s, mini-CEX, clinical work sampling, testing versus assessment, assessment of learning versus assessment for learning, integrated curricula and competency-based curricula, etc. etc. All these buzz words seem to emerge not only without a clear theoretical background but also without a clear link to each other. This must be very confusing for all the devoted teachers who try their best to teach and educate students in their specific field of expertise.

Yet, there is a consistent theoretical framework in which all these developments can be put together in a meaningful way.

In this presentation I will discuss the areas of cognitive psychological research into the nature and development of (medical) expertise, the obsolete definition of medical competence as a set of generic and independent traits and how this relates to assessment. The current - and hopefully better - definition of medical competence as a set of competencies and the implications this has for assessment. Finally I will discuss the central role of human judgement in all of this and the need for safety procedures to harness this human judgement in a programme of assessment