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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

Doing what must be done – Fourth Reconciliation Lecture by Colm McGivern
2015-03-17

Colm McGivern
Photo: Johan Roux

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Fourth Reconciliation Lecture: Audio

McGivern: speech (pdf)

The UFS Annual Reconciliation Lecture brings leaders, scholars, and the broader community together in a shared vision for social change and conflict transformation. This event is organised by Prof Pumla Gobodo-Madikizela, Senior Research Professor in Trauma, Forgiveness and Reconciliation Studies. In 2012, Nadine Gordimer, Nobel Prize Laureate for Literature, was the first speaker to deliver the lecture. This year, at the Fourth Annual Reconciliation Lecture held on the Bloemfontein Campus, Colm McGivern, Director of the British Council in South Africa, continued the legacy.

Doing what must be done
'I get down on my knees and do what must be done
And kiss Achilles' hand, the killer of my son.'
(Ceasefire by Michael Longley)

Using this poem to powerful effect, McGivern showed what reconciliation asks of each and every citizen: to do what must be done. “I think that peace and reconciliation are mutually dependent,” he said. “You can’t maintain one over the long run without attending to the other.”

South Africa’s history has tracked along a similar path to that of Northern Ireland. “And lessons from other places can be powerful and instructive,” McGivern said. Sometimes reconciliation needs a focal point for people to clearly see its power, as Madiba has for South Africa. But at other times, reconciliation needs everyday citizens to “kiss Achilles’ hand’”.

McGivern mentioned Candice Mama and her family, who  have recently forgiven Eugene de Kock,. Or as Gordon Wilson did after his daughter, Mary, died holding his hand in the 1987 Enniskillen bombing in Ireland. In a TV interview mere hours later, Wilson forgave the killers of his daughter, and  hope rippled across Ireland.

Learning from others
“People’s capability,” McGivern said, “to reconcile their own differences, however stark, can be boosted by learning from others in other places, internationally or perhaps just beyond their own identity group.” A powerful truth now being pursued in a joined initiative between the British Council and Teaching Divided Histories.

As an example, McGivern referred to the short film, ‘In Peace Apart’ where one Catholic and one Protestant girl decide to swop school uniforms. Harnessing the potential of moving images and digital media, the initiative enables teachers to explore contentious issues of history and identity in the classroom. This international field of conflict education draws lessons “from activities in Sierra Leone, India, Lebanon, and, of course, South Africa.”

Resuscitation of the national spirit of magnanimity
Here in South Africa, Archbishop Desmund Tutu has “called for a resuscitation of the national spirit of magnanimity and common purpose”, McGivern quoted. In the book, 80 Moments that Shaped the World, South Africa appears four times, McGivern pointed out. And as Archbishop Tutu wrote in the foreword of the book, “no act is unforgivable; no person or country is beyond redemption and the world needs more people to reach out to one another.”

 

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

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