Traditional approaches of assessment in the medical domain are insufficient for evaluating trainees' technical skills. Currently, many European medical training bodies are attempting to introduce competence-based training programmes for technical skills as well as other domains (e.g., communication, professional behaviour, clinical cognition). These efforts are limited due to the absence of appropriate assessment tools. Based on Competence-based Knowledge Space Theory (CbKST), a collaborative project MedCAP intends to develop a valid and reliable competence assessment procedure for one important medical skill, spinal anaesthesia. The paper briefly overviews the current states of training and assessment for medical procedural skills, describes the core ideas of CbKST, and introduces the ongoing project that will transfer the innovative approach of CbKST in personalized learning and competence assessment to the medical domain.