Beyond assessment of learning toward assessment for learning: educating tomorrow's physicians.

Beyond its importance in informing high-stakes decisions, the assessment process can also be designed to foster learning. To be effective, this requires developing a program in which curricular experiences, assessment practices and support activities are aligned to provide an educational culture that encourages self-regulated learning. We describe a program (based at Cleveland Clinic Lerner College of Medicine) in which explicit performance standards align these components and provide a roadmap for students to manage their learning. Information-rich assessment data, structured opportunities for reflection, and facilitated self-assessment using a portfolio approach are designed to support development of habits of reflective practice. Promotion depends on the achievement of competencies rather than grades. Preliminary evidence suggests that the program directs students towards learning, rather than on achieving a grade for grade's sake.