Medical competence is a hot topic surrounded by much controversy about how to define competency, how to teach it, and how to measure it. While some debate the pros and cons of competence-based medical education and others explain how to achieve various competencies, the authors of the seven chapters in The Question of Competence offer something very different. They critique the very notion of competence itself and attend to how it has shaped what we pay attention to and what we ignore in the education and assessment of medical trainees.

Two leading figures in the field of medical education, Brian D. Hodges and Lorelei Lingard, draw together colleagues from the United States, Canada, and the Netherlands to explore competency from different perspectives, in order to spark thoughtful discussion and debate on the subject. The critical analyses included in the book's chapters cover the role of emotion, the implications of teamwork, interprofessional frameworks, the construction of expertise, new directions for assessment, models of self-regulation, and the concept of mindful practice. The authors juxtapose the idea of competence with other highly valued ideas in medical education such as emotion, cognition and teamwork, drawing new insights about their intersections and implications for one another."

The invention of the Objective Structured Clinical Examination (OSCE) represented a radical break with forms of examination traditionally used to assess the competence of medical students. Unlike written or bed-side exams, an OSCE required students to perform with a series of actors in fixed-interval simulated scenarios. The technique spread rapidly and today OSCEs are used around the globe to assess health professionals. This Foucauldian socio-history explores how discourses of performance, psychometrics and production have legitimized the widespread adoption of OSCEs. Probing an archive of over 600 published articles, interviews with 25 key informants in Europe and America and visits to key universities and testing organizations, the author documents how these discourses have led to substantial changes in the way competence is understood. This book will interest those concerned about the ethical dimensions of assessment and the intersection of examination, equity, globalization and social control.