Review Articles

A framework to benchmark the quality of clinical assessment in a South African undergraduate medical programme

Hanneke Brits, Johan Bezuidenhout, Lynette J. van der Merwe
South African Family Practice | Vol 62, No 1 : Part 1| a5030 | DOI: | © 2020 Hanneke Brits, Johan Bezuidenhout, Lynette J. van der Merwe | This work is licensed under CC Attribution 4.0
Submitted: 16 November 2019 | Published: 04 February 2020

About the author(s)

Hanneke Brits, Department of Family Medicine, Faculty of Health Sciences, Free State University, Bloemfontein, South Africa
Johan Bezuidenhout, Department of Health Professions Education, Faculty of Health Sciences, Free State University, Bloemfontein, South Africa
Lynette J. van der Merwe, Department of Undergraduate Programme Management, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa

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Background: The outcome of the undergraduate medical programme is to produce clinically competent health care providers relevant for the South African context. Educational institutions find it hard to ensure the quality of assessments where competency must be assessed. This study aimed to compile an assessment framework that can be used to benchmark current assessment practices in the clinical phase of the undergraduate medical programme where competency must be certified.

Methods: In this observational, descriptive study, qualitative data were gathered using the steps described by the World Health Organization for rapid reviews. Literature was searched, screened and selected before data were analysed and a framework was constructed.

Results: Twenty-five official documents were included in the study. The framework addressed the three components of quality assessment, namely, accreditation, assessment and quality assurance. Assessors should attend to the principles of assessment, namely, validity, reliability, fairness, feasibility, educational effect and acceptability, but realise that no assessment meets all these criteria. The first step to ensure quality assessment is to identify a clear outcome. Assessment should be planned and aligned with this outcome.

Conclusion: It is clear that clinical assessment is multidimensional and that no assessment is perfect. Programme accreditation, assessment practices and psychometrics can assist to improve the quality of assessment but cannot judge clinical competence. Using experienced assessors with a variety of assessment methods on a continuous basis is the proposed way to assess clinical competence. An assessment framework can assist to improve assessment, but it cannot guarantee quality assessment.


accreditation; assessment policies; assessment guidelines; clinical assessment; quality assurance in assessment; principles of quality assessment; undergraduate assessment


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