The evaluation of competence: validity issues in the health professions.

Problems regarding the validity of competence evaluation in the health professions are widespread and difficult to resolve. This article begins by describing the origins and purpose of health professions competence evaluation, and proceeds to offer definitions of the terms competence and validity. Factors affecting the validity of competence evaluation in the health professions, including characteristics of the decision situation and the type of information customarily used to reach competence decisions, are discussed. Subsequently, an alternative model is described that holds promise for increasing the validity of competence evaluation. The article concludes with a call for greater conceptual clarity when competence evaluation in the health professions is planned and conducted.