Abstract
BackgroundThe outcome of the undergraduate medical programme is to produce clinically competent health care providers relevant for the South African context. Educational institutions find it hard to ensure the quality of assessments where competency must be assessed. This study aimed to compile an assessment framework that can be used to benchmark current assessment practices in the clinical phase of the undergraduate medical programme where competency must be certified.MethodsIn this observational, descriptive study, qualitative data were gathered using the steps described by the World Health Organization for rapid reviews. Literature was searched, screened and selected before data were analysed and a framework was constructed.ResultsTwenty-five official documents were included in the study. The framework addressed the three components of quality assessment, namely, accreditation, assessment and quality assurance. Assessors should attend to the principles of assessment, namely, validity, reliability, fairness, feasibility, educational effect and acceptability, but realise that no assessment meets all these criteria. The first step to ensure quality assessment is to identify a clear outcome. Assessment should be planned and aligned with this outcome.ConclusionIt is clear that clinical assessment is multidimensional and that no assessment is perfect. Programme accreditation, assessment practices and psychometrics can assist to improve the quality of assessment but cannot judge clinical competence. Using experienced assessors with a variety of assessment methods on a continuous basis is the proposed way to assess clinical competence. An assessment framework can assist to improve assessment, but it cannot guarantee quality assessment.
Highlights
In South Africa, undergraduate medical training programmes are offered at nine accredited universities.[1]
The Health Professions Act, 56 of 19742 was used as the original document source for national policies, the University of the Free State (UFS) assessment policy[23] for local policies and the Association for Medical Education in Europe (AMEE) and World Federation of Medical Education (WFME) websites to benchmark against international assessment principles
According to the Higher Education Act, the Ministry of Education must oversee and take responsibility for norms and standards in higher education.[30]. To assist with this task, the Minister of Education and Training established South African Qualifications Authority (SAQA) as a juristic person who must implement the objectives of the National Qualifications Framework (NQF).[18]
Summary
In South Africa, undergraduate medical training programmes are offered at nine accredited universities.[1]. Passing the final assessment of the MBChB programme enables a student to graduate and qualify as an entry-level medical practitioner.[2] The main outcome of the MBChB programme is to produce clinically competent health care providers relevant for the South African context.[3] This context is determined by the quadruple burden of disease (e.g. trauma, gastro-enteritis with dehydration, malnutrition, maternal and labour complications, human immunodeficiency virus and tuberculosis as well as lifestyle diseases),[4] which, in turn, determines the required competencies to manage these conditions. The outcome of the undergraduate medical programme is to produce clinically competent health care providers relevant for the South African context. Educational institutions find it hard to ensure the quality of assessments where competency must be assessed. This study aimed to compile an assessment framework that can be used to benchmark current assessment practices in the clinical phase of the undergraduate medical programme where competency must be certified
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