Introduction

High-stakes test have a long history in higher education and have contributed to the scientific development of educational assessment as a sophisticated discipline. Despite this, controversial reactions have emerged in different sectors of society and education professionals, questioning its real value and emphasizing its potential negative effects. A balanced discussion of these issues is needed, grounded in academic arguments about the subject, specifically in medical education.

Objective

To provide an overview of the educational implications of summative high-stakes testing, with emphasis on medical education.

Method

Narrative review of the literature. Relevant papers were identified in available databases of published and grey literature, about high-stakes testing in higher education at the international and national levels. The focus was on scholarly papers that reported methodology and results, emphasizing medical education assessment.

Discussion

High-stakes testing has had positive effects on education globally, although important negative effects have also been reported. There is abundant literature on the subject, although more than 95% are not formal published research papers, which makes it difficult to have a reasonable discussion with methodologically grounded academic arguments. The majority of studies about this theme have been published in the litigious Northamerican context, it is necessary to perform educational assessment original research in the national and local contexts, without losing the global perspective.

Conclusion

High-stakes testing have positive and negative effects on the curriculum, teaching methods and learning strategies. There is a need to use professionally and sensibly the results of educational testing, incorporating the modern interpretative concept of validity to obtain appropriate inferences of testing data.