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18 August 2025 | Story André Damons | Photo André Damons
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

Research on cactus pear grabs attention of food, cosmetic and medical industry
2015-02-18

Cactus pear
Photo: Charl Devenish

The dedicated research and development programme at the UFS on spineless cactus pear (Opuntia ficus-indica) – also known as prickly pear – has grown steadily in both vision and dimension during the past 15 years. Formal cactus pear research at the UFS started with the formation of the Prickly Pear Working Group (PPWG) in June 2002. It has since gone from strength to strength with several MSc dissertations and a PhD thesis as well as popular and scientific publications flowing from this initiative.

According to Prof Wijnand Swart from the Department of Plant Sciences, the UFS is today recognised as a leading institution in the world conducting multi-disciplinary research on spineless cactus pear.

Cactus pear for animal feed

Increasing demands on already scarce water resources in South Africa require alternative sources of animal feed – specifically crops that are more efficient users of water. One alternative with the potential for widespread production is spineless cactus pear. It is 1.14 x more efficient in its use of water than Old man saltbush, 2.8 x more efficient than wheat, 3.75 x more efficient than lucerne and 7.5 x more efficient than rangeland vegetation.

“Studies on the use of sun-dried cactus pear cladodes suggest that it has the potential to provide some 25% of the basic feed resources required by South Africa’s commercial ruminant feed manufacturing sector,” says Prof HO de Waal of the Department of Animal, Wildlife and Grassland Sciences at the UFS.

Until recently, research has focused extensively on the use of cactus pear as drought fodder. However, this is now beginning to shift, with growing interest in the intensive production of spineless cactus pear for other types of animal feed. One example is the spineless cactus pear fruit, produced seasonal, yielding large quantities of fruit in a relatively short period of a few months in summer. Unless kept in cold storage, the fruit cannot be stored for a long period. Therefore, a procedure was developed to combine large volumes of mashed cactus pear fruit with dry hay and straw and preserve it for longer periods as high moisture livestock feed, kuilmoes – a high water content livestock feed similar to silage.

Cactus pear and Pineapple juice
Photo: Charl Devenish

Cactus pear for human consumption

“In addition to its use as a livestock feed, cactus pear is increasingly being cultivated for human consumption. Although the plant can be consumed fresh as a juice or vegetable, significant value can be added through processing. This potential is considerable: the plant can be pickled; preserved as a jam or marmalade; or dried and milled to produce baking flour. It can also serve as a replacement of egg and fat in mayonnaise,” said Dr Maryna de Wit from the Department of Microbial, Biochemical and Food Biotechnology.

The extraction of mucilage from fresh cladodes can form a gelling, emulsifier, and fat-replacing agent commonly found in food products such as mayonnaise and candy. During an information session to the media Dr De Wit and her team conducted a food demonstration to showcase the use of the cladodes in a juice, chicken stir-fry, biscuits and a salad.

The extrusion of cactus pear seed oil provides a further lucrative niche product to the array of uses. These include high-value organic oil for the cosmetic sector, such as soap, hair gel and sun screens.

The cladodes and the fruit also have medicinal uses. It has anti-viral, anti-inflammatory, pain killing and anti-diabetic agents. It is also high in fibre and can lower cholesterol. The fruit also prevents proliferation of cells and suppresses tumour growth and can even help to reduce a hangover.

In South Africa the outdated perception of cactus pears as thorny, alien invaders, is rapidly disappearing. Instead, farmers now recognise that cactus pear can play a vital role as a high yielding, water-efficient, multi-use crop, said Prof de Waal and the members of the Cactus Pear Team.

Facebook photo gallery
Dagbreek interview with Dr Maryna de Wit  

Research on cactus pear (read the full story)

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

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