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This study proposes a new assessment method, case-based assessment, using cases containing complex and real-world situations to assess learners’ problem-solving abilities through a reasoning process. First, the study aims to explore the characteristics of case-based assessment by reviewing case-based learning. We then identify two major reasoning models in medical education settings to develop case-based assessment for diagnostic reasoning processes. It will serve as a conceptual framework to design case-based assessment for real-world problem-solving.