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Universities should ensure their assessments are sound and defendable

18 August 2025 | Story André Damons | Photo André Damons

Universities have an obligation to ensure that their assessments are sound and defendable when they confer degrees for professional qualifications, such as in medicine. Can institutions confidently defend these results and what are the implications if they pass a student who is not competent?

These were some of the questions Prof Hanneke Brits, a family medicine specialist at the Free State Department of Health, as well as the Department of Family Medicine, at the University of the Free State (UFS), addressed during her inaugural lecture on Tuesday (12 August). The UFS, she concluded at the end of her lecture, titled To pass or not to pass: Can we confidently defend the outcome of our assessments? can defend its clinical assessments with the implementation of effective workplace-based assessment and trained examiners.

The implications of passing incompetent students

According to Prof Brits, who has supervised numerous undergraduate and postgraduate student research projects, she chose this topic because decisions have consequences. She gave an overview of the assessments in the clinical years of the undergraduate medical programme. In so doing, she also answered other questions including what may happen when universities pass students who are not competent and what may happen if they fail competent students. When the university passed a candidate, she said, that candidate may register with a professional body like the Health Professions Council of South Africa to work as a doctor.

“What are the implications if we fail to fail a student who is not competent? The implications are that patients may suffer if they are treated by an incompetent doctor, which may lead to the doctor running into trouble if it is found that their work is not up to standard. This may further lead the faculty being labelled as poor for training substandard doctors.

“The throughput rate of the university may go down and the university may not get subsidy for the students. The student must repeat his module with a lot of emotional and financial burden. They public may suffer because there are not enough healthcare professionals to treat them. Therefore, we must get this right,” she said.

When assessing students, assessors should start at the bottom: students should know, then they should know how, then they should show how and then they must do. All assessments should meet the basic requirements of validity, reliability, fairness, educational impact and feasibility, explains Prof Brits.

Workplace-based training and assessment

During her PhD study, she looked specifically at assessments in the clinical years of the undergraduate medical programme. “It is quite complicated,” said Prof Brits, “to do assessment for professional qualifications as you need to obey to the rules and regulations of the Department of Education, the Department of Health, the Health Professions Council of South Africa, the Colleges of Medicine of South Africa because they are our examining body, as well as our own university rules and international assessment guidelines and best practices.”

She compiled a framework to measure what they do at the UFS and found that the decision reliability was excellent – meaning the students that passed during the year passed at the end of the year and those that failed, failed. The reliability of some of the methods used for the final assessment was not good, however, if more assessments with supplementary exams were included, it was better.

The conclusion of her study was that the UFS mostly complied with the regulations of the regulatory bodies. The recommendation from this study was to implement workplace-based assessment (WBA) to improve both the validity and reliability of assessments and to make it more defendable. Prof Brits explained that WBA is where students get regular assessment and feedback while they work and receive training in hospitals or clinics. “For example, the student is seeing a patient in the emergency department who was stabbed with a knife on his hand. Is the student able to assess the severity, can the student manage the wound and what about follow-up?

“The advantage of WBA is that we train in real life situations and manage conditions that occur commonly. In real life situations, students use many senses while learning, e.g., seeing, hearing, touching, smelling, which all enhance knowledge retention. It is important that students receive feedback and that we document these encounters. To ensure a holistic approach to the management of patients we use Entrustable Professional Activities or EPAs – something that I can trust a person to do. It is a combination of knowledge, skills and attitudes.”

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Premiere of the documentary on King Moshoeshoe - Address by the Rector

2004-10-14

Address by the rector and vice-chancellor of the University of the Free State, prof Frederick Fourie, at the premiere of the documentary on King Moshoeshoe, Wednesday 13 October 2004

It is indeed a privilege to welcome you at this key event in the Centenary celebrations of the University of the Free State.

We are simultaneously celebrating 100 years of scholarship with 10 years of democracy

Today is a very important day with great significance for the University. This Centenary is not merely a celebration of an institution of a certain age. It is a key event in this particular phase of our history, in our transformation as an institution of higher learning, in taking the creation of a high-quality, equitable, non-racial, non-sexist, multicultural and multilingual university seriously.

This is about building something new out of the old, of creating new institutional cultures and values from diverse traditions.

It is about learning together - as an higher education institution - about who we are where we come from – to decide where we are going.

It is about merging the age-old tradition of the university, of the academic gown, with the Basotho blanket, the symbol of community engagement.

Then why is it important that we remember Moshoeshoe, where does he fit into our history?

In the Free State province, where large numbers of Basotho and Afrikaners (and others) now live together, a new post-apartheid society is being built in the 21st century.

The challenge is similar to that faced by Moshoeshoe 150 years ago. As you will see tonight, he did a remarkable thing in forging a new nation out of a fragmented society. He also created a remarkable spirit of reconciliation and a remarkable style of leadership.

Not all people in South Africa know the history of Moshoeshoe. Many Basotho – but not all – are well versed in the history of Moshoeshoe, and his name is honoured in many a street, town and township. Many white people know very little of him, or have a very constrained or even biased view of his role and legacy. In Africa and the world, he his much less known than, for instance, Shaka. (In Lesotho, obviously, he is widely recognised and praised.)

We already benefit from his legacy: the people of the Free State share a tradition of moderation and reconciliation rather than one of aggression and domination.

With Moshoeshoe, together with Afrikaner leaders and reconciliators such as President MT Steyn and Christiaan de Wet, we have much to be thankful for.

Our challenge is take this legacy further: to forge a new society in which different cultural, language and racial groups – Basotho, Afrikaners and others – will all feel truly at home.

Bit by bit, on school grounds, on university campuses, in each town and city, people must shape the values and principles that will mould this new non-racial, multicultural and multilingual society.

A shared sense of history, shared stories and shared heroes are important elements in such a process.

Through this documentary film about King Moshoeshoe, the UFS commits itself to developing a shared appreciation of the history of this country and to the establishment of the Free State Province as a model of reconciliation and nation-building.

Moshoeshoe is also a strong common element, and binding factor, in the relationship between South Africa / the Free State, and its neighbour, Lesotho.

For the University of the Free State this also is an integral part of real transformation – of creating a new unity amidst our diversity.

Transformation has so many aspects: whilst the composition of our student and staff populations have been changing, many other things change at the same time: new curricula, new research, new community service learning projects.

In also includes creation of new values, new (shared) histories, new (shared) heroes.

It includes the incorporation of the Qwaqwa campus, which serves a region where so many of the children of Moshoeshoe live, including her majesty Queen Mopeli.

We see in Moshoeshoe a model of African leadership – of reconciliation and nation-building – that can have a significant impact in South Africa and Africa as a whole.

We also find in the legacy of King Moshoeshoe the possibility of an “founding philosophy”, or “defining philosophy”, for the African renaissance.

To develop this philosophy, we must gain a deeper understanding of what really happened there, of his role, of his leadership.

Therefore the University of the Free State will encourage and support further research into the history, politics and sociology of the Moshoeshoe period, including his leadership style.

We hope to do this in partnership with National University of Lesotho.

The Moshoeshoe documentary is one element of a long-term project of the UFS. The other elements of the project that we are investigating are possible PhD-level research; a possible annual Moshoeshoe memorial lecture on African leadership; and then possible schools projects and other ways and symbols of honouring him.

It is my sincere wish that all communities of the Free State and of South Africa will be able to identify with the central themes of this documentary, and develop a shared appreciation for leaders such as King Moshoeshoe and the legacy of peace, reconciliation and nation-building that they have left us.

Prof. Frederick Fourie
Rector and Vice-Chancellor
University of the Free State
13 October 2004.

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