Institutional Capacity for Competency-Based Assessment: Governance Challenges in Professional Higher Education

Competency-based assessment (CBA) frameworks are widely adopted in professional higher education, yet implementation outcomes vary drastically. This study reconceptualizes CBA reform as a governance issue rather than a technical design problem, using medical education and Chinese clinical teaching as cases. It identifies three core governance dimensions: authority structures, organizational routines and resources, and sociocultural contexts. Three endemic tensions emerge: the formative-summative paradox, reliability-feasibility trade-off, and cultural moderation of transferability. These tensions demand ongoing institutional management rather than technical fixes. Findings highlight that institutional governance capacity, not tool sophistication, determines CBA reform success, with implications for cross-cultural policy borrowing and professional education governance.