Peer assessment of professional competence Elaine F Dannefer, 1 Lindsey C Henson, 2 S Beth Bierer, 3 Tana A Grady-Weliky, 4 Sean Meldrum, 5 Anne C Nofziger, 5 Craig Barclay 6 & Ronald M Epstein 5 BACKGROUND Current assessment formats for medical students reliably test core knowledge and basic skills. Methods for assessing other important domains of competence, such as interpersonal skills, humanism and teamwork skills, are less well developed. This study describes the devel- opment, implementation and results of peer assessment as a measure of professional compet- ence of medical students to be used for format- ive purposes. METHODS Year 2 medical students assessed the professional competence of their peers using an on- line assessment instrument. Fifteen randomly selec- ted classmates were assigned to assess each student. The responses were analysed to determine the reli- ability and validity of the scores and to explore rela- tionships between peer assessments and other assessment measures. RESULTS Factor analyses suggest a 2-dimensional conceptualisation of professional competence: 1 fac- tor represents Work Habits and the other factor represents Interpersonal Habits, including respect and trustworthiness. The Work Habits factor had moderate, yet statistically significant correlations ranging from 0.21 to 0.53 with all other performance measures that were part of a comprehensive assess- ment of professional competence. Approximately 6 peer raters were needed to achieve a generalisability coefficient of 0.70. CONCLUSIONS Our findings suggest that it is possible to introduce peer assessment for formative purposes in an undergraduate medical school pro- gramme that provides multiple opportunities to interact with and observe peers. KEYWORDS education, medical, undergraduate ⁄ *standards; educational measurement ⁄ *standards; professional competence ⁄ *standards; attitude of health personnel; peer review; students, medical; reproducibility of results. Medical Education 2005; 39: 713–722 doi:10.1111/j.1365-2929.2005.02193.x INTRODUCTION Medical education has increasingly focused on defining professional competencies, developing competency-based curricula and constructing viable assessment tools. 1,2 Although discrete dimensions of professional competence have been delinea- ted, 3,4 strategies that simultaneously assess multiple dimensions of competence remain elusive, partic- ularly approaches that reliably measure not only knowledge and technical skills but also interper- sonal and humanistic qualities that, increasingly, are becoming explicitly recognised as core to being a doctor. 2,5–10 Professional competence requires consideration of both cognitive and student assessment 1 Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA 2 Department of Anaesthesiology, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA 3 Cleveland Clinic Center for Medical Education Research and Development, Cleveland, Ohio, USA 4 Department of Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA 5 Department of Family Medicine and Rochester Center to Improve Communication in Health Care, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA 6 Warner Graduate School of Education, University of Rochester, Rochester, New York, USA Correspondence: Elaine F Dannefer PhD, Director, Medical Education Research and Evaluation, Cleveland Clinic Lerner College of Medicine, NA ⁄ 24, 9500 Euclid Avenue, Cleveland, Ohio 44195, USA. Tel: 00 1 216 445 1058; Fax: 00 1 216 445 7442; E-mail: dannefe@ccf.org Ó Blackwell Publishing Ltd 2005. MEDICAL EDUCATION 2005; 39: 713–722 713