Perspectivism and Health Professions Assessment

Acad Med. 2024 May 13. doi: 10.1097/ACM.0000000000005765. Online ahead of print.

Abstract

This article aims to outline perspectivism and perspectival thinking by drawing on established scholarship from the philosophy of science and to demonstrate its relevance to health professions education. Perspectivism embraces the notion that knowledge always inherently arises from particular perspectives. "Truth" always depends on an evaluative background. Perspectivism is a form of epistemic humility that sees epistemic claims (relating to knowledge) as fundamentally historically and contextually situated. This article contends that perspectivism is a fruitful and relevant lens to apply to health professions assessment. It is a way of thinking that is all around us, even if we do not realize it. It extends discourse around the value of subjectivity in assessment and may cut through many prevailing debates on assessment practice. Perspectivism is a sort of middle-ground that is not meant to be another idea or "-ism" to add to a list of ideas, but constitutes a shift in how philosophy can be applied by adopting a broader, more holistic perspective. Applying a perspectival lens to health professions education embraces the imperative to make interpretive processes in assessment philosophically explicit. This opens the possibility of adopting multiple philosophical stances concurrently and allows actors to appreciate different methodological viewpoints with more charity. This scholarly perspective encourages the assessment community to continue to innovate through an appreciation of the importance of a wide range of assessment perspectives by uncovering the drivers of specific commitments to philosophical positions. Although the focus is on assessment in the health professions, perspectival thinking has the potential to advance medical education discourse and practice more generally beyond assessment. The hope with this essay is that by encouraging more critical reflection, this description of perspectival thinking will further aid researchers and practitioners in health professions education to better understand what is happening philosophically with more frequency.