Standard setting in medical education: fundamental concepts and emerging challenges

The process of determining the minimum pass level to separate the competent students from those who do not perform well enough is called standard setting. A large number of methods are widely used to set cut-scores for both written and clinical examinations. There are some challenging issues pertaining to any standard setting procedure. Ignoring these concerns would result in a large dispute regarding the credibility and defensibility of the method. The goal of this review is to provide a basic understanding of the key concepts and challenges in standard setting and to suggest some recommendations to overcome the challenging issues for educators and policymakers who are dealing with decision-making in this field.