Assessment at last.

'Assessment is an integral part of the educational process." G ENERAL practice, although the largest medical specialty, Jwas one of the last to enter the universities and medical schools and therefore to become involved with teaching. When it did so in the early 1970S2 general practitioners turned to the edu-cationalists for advice and guidance and as a result adopted a formal model of learning, the educational paradigm. This was later simplified to the 'training triangle'3 which emphasized the key points in serious teaching programmes: objectives, methods and assessment. General practice all over the world spent much of the 1970s concentrating on working out the objectives of vocational training. The British book The future general practitioner: learning and teaching4 was followed in Australia by Focus on learning in family practice,5 and similar work was done in Canada. All this enabled the tasks of the modern general practitioner to be reviewed and defined. It is no coincidence that this was the decade when the main job descriptions of the general practitioner , such as those determined by the Royal College of General Practitioners4 and the Leeuwenhorst group,6 were agreed. Whereas the 1970s had concentrated on objectives, the 1980s were devoted to methods. This was the era of consultation analysis and all its models, of small group teaching on vocational training courses, and of the beginning of distance learning; but the striking advance was in the use of videorecording to capture and replay the subtle behaviours of patients and doctors, which young doctors so often miss when learning their craft. Sooner or later it was inevitable that attention would turn to the third point of the training triangle, assessment, and this has proved the toughest challenge so far. The first step was taken by the Merrison committee' with its simple statement, accepted by the profession, that 'assessment is an integral part of the educational process'; in other words, educational programmes which do not include assessment are incomplete. However, there are two kinds of assessment and the clarification originally introduced by Miller7 in the United States of America has been helpful. Educational or formative assessment is assessment for the benefit of the learner: it is open and fed back to the learners to let them know how they are doing. Summative or terminal assessment is quite different. This is for the benefit of patients and society, to ensure that those who are to have …