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Prof Hanneke Brits
Prof Gert van Zyl, Dean for the Faculty of Health Sciences, 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), Prof Anthea Rhoda, Deputy Vice-Chancellor: Academic, and Prof Nicholas Pearce, Head of the School of Clinical Medicine before the inaugural lecture.

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.”

News Archive

ANC is not a party of the people - Mbeki
2010-08-30

 

 

“The unions in this country do not understand the political economy of South Africa. They think that the ANC is the party of the people. The ANC is the party of the black middle class. The fact that the masses vote for it does not mean they control it. The policies of the ANC favour the black middle class and the established businesses. They do not favour the working class.”

This was said by renowned economic and political commentator Mr Moeletsi Mbeki, brother of former president Thabo Mbeki, during a guest lecture he recently presented to Economics students of the University of the Free State (UFS) in Bloemfontein.

“You just have to look at the types of houses that the ANC government builds for ordinary South Africans,” he said.

“If you had a party that was a pro-working class party it would not have built these so-called RDP houses that are being built by the ANC government. The unions have all along been under the illusion that the ANC is the government of the working class and (Zwelinzima) Vavi and them are now beginning to realise that this is not the case.

“The public-sector workers are in a special dilemma. They think the ANC is their ally but at the same time they feel they are not getting any benefits out of this alliance. Therefore you are beginning to get a very acrimonious environment emerging between the public-sector unions and the government.”

Regarding the current issue of the Protection of Information Bill and the proposed media tribunal that have brought the media and the government onto a collision course, Mbeki said the ANC government was trying to muzzle the media because it wanted to safeguard corruption within government.

“The question of freedom of information is very closely linked to the rise in corruption in the government,” he said.

“What the politicians are doing is that they are trying to hide that corruption. The media in this country have been playing a very critical role in exposing cases of corruption. That is why Vavi now has bodyguards.”

He said he recently met Vavi, the General Secretary of Cosatu, surrounded by four bodyguards. He said Vavi told him that he was getting death threats because he was opposing corruption in government.

Mbeki said the economic policies of South Africa were the “worst in the world” because they benefited people who were already rich and militated against the emergence of entrepreneurs.

“In fact, one of the serious downsides of Black Economic Empowerment (BEE) is that it takes people who should normally be entrepreneurs and who should be creating new companies and new jobs, out of that space and just makes them wealthy. BEE has been a disaster because it created this massive economic inequality; it created this class of idle rich who have tons of money but do nothing,” he added.

He said the under-investment in the economy was having dire consequences in terms of unemployment and poverty. He said this, coupled with the growth of consumption that Black Nationalism was driving, was actually driving down the ability of the economy to absorb labour.

“What really lies at the bottom of our economic problems in South Africa is that we have too much of a one-party dominance of our political system. We need more competition in our political system and until we realise the policies of the ANC are not going to change,” he said.

Mbeki’s guest lecture was on the topic: Architects of Poverty: Why African capitalism needs changing.

Media Release
Issued by: Mangaliso Radebe
Assistant Director: Media Liaison 
Tel:   051 401 2828
Cell:  078 460 3320
E-mail:  radebemt@ufs.ac.za  
30 August 2010

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