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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

UFS enhances Geography in schools
2015-05-11

The Green Box

The Department of Geography at the University of the Free State (UFS), in association with the Society of South African Geographers (SSAG), is doing their part in providing curriculum support to schools. Dr Ruth Massey and Anneri Pretorius are the project managers of Green Box, an initiative to advance Geography in schools.

The Green Box supports the intermediate phase of schooling (Grades 4, 5, 6). According to Dr Massey, the worksheets and activities provided in the Green Box are aligned with the Curriculum and Assessment Policy Statements (CAPS) and the new curriculum. “These worksheets are divided into three themes: map work, physical Geography, and human Geography.

“Map work includes symbols and keys, grid references, and compass work whilst physical Geography focuses on water and waste, biodiversity and conservation, and weather and climate issues. The human Geography theme has a focus on population, rural and urban development, migration, food and farming, and transport and trade,” she said.

Each worksheet has a fact sheet section which teaches theory on the specific topic (linked to the curriculum), an activity section (all resources needed for these activities are provided in the box), and a ‘take it home’ section for further learning and practice at home.

The Green Box is a recycled plastic crate that comprises worksheets, training materials, visual aids, and resources for teaching, learning, and active engagement in Geography classes.

Also included in the box are a felt story board and characters (that link with the worksheet activities), the ‘Climate Change memory game’ (which enhances learner’s memory capabilities and teaches various climate change facts) and the ‘Sustainable Development puzzle game’ (which teaches about the social, biophysical, economic, and political elements of Sustainable Development, and how they overlap).

“All items in the box are locally sourced, robust, and without copyright,” said Dr Massey.

The project is focusing on 10 under-resourced schools in the Bloemfontein area. Each school has received three boxes (one for each grade of the Intermediate Phase).

Dr Massey said: “This box is to be shared among the teachers. The Green Boxes were distributed at a training and information workshop held at three central schools in the various districts. These workshops introduced the teachers to the contents of their box, and provided basic training on the worksheets and the activities provided.”

“The schools will be joined up with ‘Box Buddies’ at more resourced schools in Bloemfontein. These buddy schools will assist in support and in replenishing the box’s stationery, etc. when needed.”

“Monitoring and evaluation will take place for six months after the boxes have been distributed. This will ensure support to, and the sustainability of, the project.” The Green Box project was made possible through a grant from the Society of South African Geographers (SSAG).

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