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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

Reverend Frank Chikane honours ‘Oom Bey’ at second Beyers Naudé Memorial Lecture for 2012
2012-09-11

Rev. Frank Chikane and Dr Choice Makhetha, Vice-Rector: External Relations at the UFS.
Photo: Stephen Collett
10 September 2012

The 9th Beyers Naude Memorial Lecture, a partnership initiative between the University of the Free State (UFS) and Kagiso Trust, was held on the South Campus of the university last week. The theme of the lecture focused on Collaborative partnership for social cohesion: Building of a nation with ethics.

Guest speaker, Reverend Frank Chikane, is a member of the UDF, ANC, Director-General in the Office of the President and a board member of Kagiso Trust.

In his speech, Rev. Chikane focused on the first 45 years in the life of Beyers Naudé, sketching a picture of a man who lived for what he believes in. When this former minister of the South African Dutch Reformed Church and member of the Broederbond, decided to question the morality of the Apartheid government after the Sharpeville Massacre in 1960, he made some changes in his beliefs and started to play a big role in the struggle against apartheid.

“If one know about ‘Oom Bey’s’ earlier life, you will see how radical his contribution was in turning South Africa from a country on the brink of destruction to a country of peace. ‘Oom Bey’ must be seen as a role model, someone we can aspire to be in South Africa today,” Rev. Chikane said.

“From his legacy one sees elements of someone building a nation with ethics.

“He took sides with the poor against an unjust system. Power breaks cohesion. It makes people not to think,” Rev. Chikane said.

If Afrikaners and black people stood together after the South African War (Anglo-Boer War), we would have talked a different language today. However, they did not. Afrikaners stood together, excluding black people and cohesion between all races was destructed. ‘Oom Bey’ tried to build relationships between people from all races in South Africa in an effort to create peace amongst all people. He was alienated from the Broederbond and defrockedrom the church.

In his speech, Rev. Chikane also said that South Africa did not succeed in collaborative partnerships in terms of the economy. “We need collaborative action to change our economy. This specific failure can destroy all that we have built together.”

“All South Africans can be like ‘Oom Bey” and make a contribution, especially in terms of the economy. To deal with this challenge, we can all contribute. This is important because due to a poor economy, many people are desperate and desperate people can destroy any relationship that we might have built so far.”

At this event, the university and Kagiso Trust also announced the winners of a poetry and essay competition that coincided with this last Beyers Naudé lecture for 2012. The award ceremony looked at the creativity of the learners, how they expressed themselves as well as the novelty of their work. Students as well as learners from schools in the Free State participated in the competition and first, second and third place winners received cash prizes as well as a book from Rev. Frank Chikane for their brilliant work.
 

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