As outcome-based education has taken hold worldwide, many new findings on learner assessment have emerged. In addition, with the COVID-19 pandemic and the rapid spread of generative artificial intelligence, the situation surrounding learner assessment is entering a new phase. Now is the time to review the historical transition of modern learner assessment in the world and in Japan, to clarify our inherent value criteria for learner assessment, and to discuss the future prospects for learner assessment. This paper will explain the key issues related to learner assessment in the context of past and present trends.

　This paper describes the concepts of assessment theory which are necessary to implement the most desirable assessments, with a particular focus on validity and utility. Validity, classically defined as a trinity of content, criterion-related, and construct, is now encompassed by construct validity. By distinguishing between validity and validation, the process of reinforcing validity through argument-based validation is proposed. Furthermore, we refer to the concept of utility, which takes into account practicality (acceptability and cost) and educational impact, in order to make the assessment practice sustainable. Finally, we will address how learner assessment relates to program evaluation.

　This paper describes test theory, which is the theoretical foundation of learner assessment, in relation to its application in Common Achievement Tests. To be specific, classical test theory and the reliability coefficients, generalizability theory, and item response theory are taken up. In classical test theory, the observed score X is expressed as the sum of a true-score component T and an error component E. The ratio of the true-score variance to the observed score variance defines the reliability coefficient. Generalizability theory is an extension of the notion of reliability in classical test theory. Item response theory overcomes the limitations of classical test theory and can express the properties of items (difficulty and discrimination) and examinees’ abilities separately.

　This paper discusses learner assessment, introducing a classification based on quantitative and qualitative assessment paradigms while exploring rubrics and Entrustable Professional Activities (EPAs) emphasizing performance-based assessment. Rubrics, with their clear standards and criteria for assessment, can effectively function as formative assessments in both undergraduate education and postgraduate training. Within workplace-based assessments, rubrics permit an analytical assessment of competencies under a shared framework across various fields and clinical departments. In contrast, EPAs assess a bundle of competencies by determining whether supervising physicians can entrust specific professional activities to physicians in training. Various assessment methods exist in medical education, each with its advantages and limitations. Understanding these is crucial for selecting and implementing the most suitable assessment method based on the intended purpose.

　Compared to design methods of learning, learner assessment is not as systematic. The concept of learner assessment in health professions education has continued to evolve and has been significantly transformed since the early 2000s when Van der Vleuten proposed Programmatic assessment. Programmatic assessment is based on the philosophy that assessment is not an activity to cut out a part of learners’ competencies and judge learning outcomes at a scattered time (assessment of learning), but an activity to systematically assess learner’s competencies and link the results to learning (assessment for learning). This paper outlines the basic principles of programmatic assessment, introduces an example of programmatic assessment implementation, and discusses issues to be addressed when programmatic assessment is introduced into Japanese medical education.

　Saitama Medical School offers practical training in physiology to second-year medical students. Due to the increase in COVID-19 infections, one of the courses, “Nerve Excitation and Conduction” was conducted as remote practical training in 2021. The remote practical training was conducted with the same content as face-to-face practical training. In this course, students watched experimental videos. then they used Zoom and Google Slides to analyze and discuss the reconstructed data which they had obtained the previous year. As a result, the remote practical training provided a uniform training opportunity unlike the face-to-face practical training. Thus, we believe that the learning effectiveness of remote practical training was sufficient, although some improvements are needed. Educational content for fully online practical training is highly useful.

　In the revised Core Curriculum, professionalism is listed as one of the basic qualities and abilities required of physicians. The definition of professionalism and related learning objectives (1. trust, 2. compassion, 3. liberal arts, and 4. bioethics) are also presented. However, the Core Curriculum does not explain why these objectives were listed. Therefore, some of them are difficult to understand or differ from what has been discussed in previous meetings of the current subcommittee (and previous committees). To properly and effectively advance professionalism education, it is necessary to confirm the contents of the revised Core Curriculum that are insufficient or inappropriate. It is also necessary to deepen the discussion for the next revision of the Core Curriculum. A symposium was held for this purpose. The main points of each lecture are presented within this report.