Original Research

Evidence of learning in workplace-based assessments in a Family Medicine Training Programme

Neetha J. Erumeda, Ann Z. George, Louis S. Jenkins
South African Family Practice | Vol 66, No 1 : Part 2| a5850 | DOI: https://doi.org/10.4102/safp.v66i1.5850 | © 2024 Neetha Joe Erumeda, Ann Zeta George, Louis Stander Jenkins | This work is licensed under CC Attribution 4.0
Submitted: 19 October 2023 | Published: 26 April 2024

About the author(s)

Neetha J. Erumeda, Department of Family Medicine and Primary Care, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; and Gauteng Department of Health, Ekurhuleni District Health Services, Germiston, South Africa
Ann Z. George, Centre of Health Science Education, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Louis S. Jenkins, Division of Family Medicine and Primary Care, Faculty of Medicine and Health Science, Stellenbosch University, Cape Town, South Africa; and Western Cape Department of Health, George Hospital, George, South Africa; and Primary Health Care Directorate, Department of Family, Community and Emergency Care, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa


Background: Learning portfolios (LPs) provide evidence of workplace-based assessments (WPBAs) in clinical settings. The educational impact of LPs has been explored in high-income countries, but the use of portfolios and the types of assessments used for and of learning have not been adequately researched in sub-Saharan Africa. This study investigated the evidence of learning in registrars’ LPs and the influence of the training district and year of training on assessments.

Methods: A cross-sectional study evaluated 18 Family Medicine registrars’ portfolios from study years 1–3 across five decentralised training sites affiliated with the University of the Witwatersrand. Descriptive statistics were calculated for the portfolio and quarterly assessment (QA) scores and self-reported clinical skills competence levels. The competence levels obtained from the portfolios and university records served as proxy measures for registrars’ knowledge and skills.

Results: The total LP median scores ranged from 59.9 to 81.0, and QAs median scores from 61.4 to 67.3 across training years. The total LP median scores ranged from 62.1 to 83.5 and 62.0 to 67.5, respectively in QAs across training districts. Registrars’ competence levels across skill sets did not meet the required standards. Higher skills competence levels were reported in the women’s health, child health, emergency care, clinical administration and teaching and learning domains.

Conclusion: The training district and training year influence workplace-based assessment (WPBA) effectiveness. Ongoing faculty development and registrar support are essential for WPBA.

Contribution: This study contributes to the ongoing discussion of how to utilise WPBA in resource-constrained sub-Saharan settings.


assessment for learning; assessment of learning; formative assessments; workplace-based assessments; work-based learning; family physician; family medicine; learning portfolio

Sustainable Development Goal

Goal 4: Quality education


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