Validation focuses on evaluating the key claims, assumptions and inferences that link assessment scores with their intended interpretations and uses. The Implications and associated decisions are the most important inferences in the validity argument.

Over the past twenty-five years, professionalism has emerged as a substantive and sustained theme, the operationalization and measurement of which, has become a major concern for those involved in medical education. However, how to go about establishing the elements that constitute appropriate professionalism in order to assess them is difficult. Using a discourse analysis approach, the International Ottawa Conference Working Group on Professionalism (IOCPWG) studied some of the dominant notions of professionalism, and in particular the implications for its assessment. The results presented here reveal different ways of thinking about professionalism that can lead toward a multi-dimensional, multi-paradigmatic approach to assessing professionalism at different levels: individual, inter-personal, societal-institutional. Recommendations for research about professionalism assessment are also presented.

Successfully blending assessment and feedback demands clarity of purpose, support for learners, and a system and organisational commitment to a culture of improvement rather than a culture of performance.