Assessment for assessment's sake

This chapter examines why and how clinicians are tested, separating formative from summative assessment and listing the real drivers: legal cover, quality assurance, spotting outliers and motivation. The push for objectivity and defensibility, the authors argue, produces exams that map poorly onto actual practice. They criticise closed-book finals, the move from essays to single best answers, situational judgement tests and the gap between workplace assessments as designed and as gamed. Their recurring alternative is the detailed logbook, shown through Nagendran's own record of emergency intubations with columns for difficulty and lessons learned. They also propose confidence-calibrated answers, trained assessors and discreet observation, while noting the Hawthorne effect.