Dr Kevin Eva's
Where hath the pendulum swung in clinical assessment? Choosing between expert judgment and objective tools
"In 2007, Hodges used Scylla and Charybdis, the dangers Odysseus had to choose between on his journey, as a metaphor for the difficulty of navigating between “excessive examination and naïve reliance on self-assessment”. The metaphor is an equally fitting description of the difficulties we face navigating between objectification and judgment in assessment. Do we choose to crash up against the rocky shore of checklists and the atomization of medicine they promote or get sucked down into the whirlpool that is subjectivity and the concerns about fairness/defensibility that go with it? In this talk I will review the literature contributing to the debate in an effort to highlight both the value and fallibility of subjectivity in clinical assessment, highlighting strategies for optimizing the benefits gained from reliance on judgment, and concluding with an examination of a number of unresolved questions that are in need of answers in this age of competence-based models of education."
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