Navigating the discomfort dilemma in work-based assessment

This conceptual paper reflects on the role of discomfort in work-based assessment based on a joint keynote address at the 2025 MedEd on the Edge conference. The authors draw together findings from several of their own qualitative studies and locate this integration in the broader literature. They consider when and how discomfort can be either productive or unproductive during work-based assessment and how supervisors and trainees contribute to it. To illustrate key considerations, short quotes from their published qualitative data are embedded throughout to add richness to these concepts and, more importantly, give health professional trainees their due 'voice' in this important discourse. In doing so, the authors expand the traditional conceptualisations of WBA to include informal moments of appraisal and explore the role of self-assessment in transformative learning. Finally, tangible guidance is provided for clinical educators in their interaction with clinical trainees.