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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.”

News Archive

Eugene de Kock, FW de Klerk and forgiveness – Prof Gobodo-Madikizela’s take on gestures of reconciliation

2015-02-06

What Prof Pumla Gobodo-Madikizela, Senior Research Professor in Trauma, Forgiveness and Reconciliation Studies at the University of the Free State, found over the years talking to Eugene de Kock, was a man tortured by his past. By the deeds he has committed.

“As a result he was confronting these – not as a cog in a machine – but as a person who actually did the deed himself,” Prof Gobodo-Madikizela said during an interview [https://soundcloud.com/primediabroadcasting/dr-gobodo-on-de-kock-parole] with Pippa Hudson on Cape Talk. A man taking personal responsibility.

Against the backdrop of De Kock recently granted parole, what, then, is the nature of forgiveness?

“Often people think when they forgive, you forgive and forget. That’s not the point,” Prof Gobodo-Madikizela says. “Forgiving, in fact, I found is the wrong word. We are using forgiveness for a range of responses. What I find useful in this kind of work is to think about how people change, how people are transformed. In other words, to think about our empathic connection to people who are our former enemies.” In other words: to reach a place where both parties can see each other as fellow human beings. “Somehow when a person expresses remorse – in the way Eugene de Kock has done – it opens a door for the different kinds of relationships to that traumatic past,” Prof Gobodo-Madikizela says.

In an article for the Sunday Times, Prof Gobodo-Madikizela refers to the motion to immortalise F W de Klerk by renaming Table Bay Boulevard after him. In this piece, she clearly points out that De Klerk is not without blood on his hands. She agrees with Mayor Patricia de Lille’s support of this tribute to De Klerk, though, when De Lille refers to ‘the spirit of reconciliation that Tata Madiba believed in’.

Justice Minister Michael Masutha – who granted De Kock parole – and De Lille “are right in evoking the memory of Nelson Mandela through these important gestures of reconciliation,” Prof Gobodo-Madikizela remarks. The need to return to Nelson Mandela’s vision, she adds, remains urgent.

Read Prof Gobodo-Madikizela’s full article, published in the Sunday Times, here.
For Prof Gobodo-Madikizela’s response to Eugene de Kock, FW de Klerk and reconciliation, read here.

For more information or enquiries contact news@ufs.ac.za

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