Browsing by Author "Tan, Christina Phoay Lay"

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    An investigation into the exit level assessment of the clinical competence of medical graduates for the Sub-Saharan African context
    (Stellenbosch : Stellenbosch University, 2017-12) Tan, Christina Phoay Lay; Van Schalkwyk, Susan; Cilliers, Francois; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Health Professions Education.
    ENGLISH SUMMARY : Assessment plays a major role in the process of medical education and is an essential component of any medical curriculum. In order to allow judgements to be made on the competence of students, the quality of assessment methods needs to be assured. As exit-level assessments are used for licensing and certification purposes, they are regarded as “high-stakes” in nature, with significant implications for the student, the curriculum, the institution and the public. This study investigated how valid exit-level assessment practices are in determining the clinical competence of medical graduates for selected health-related issues, with the focus on selected medical schools in Sub-Saharan Africa where there are resource constraints and a high burden of disease. It was warranted in light of the paucity of published information about assessment practices and factors that could influence the decisions that are made in exit level assessment in Sub-Saharan Africa The study was conducted within a qualitative interpretive paradigm. A range of data-gathering methods were utilised. The research design selected was multiple case studies, with the unit of analysis the exit-level assessment practices of undergraduate medical curricula. Three medical schools in Sub-Saharan Africa were purposively selected, and as a proxy for the entire curriculum, the clinical disciplines of Obstetrics & Gynaecology and Paediatrics were specifically chosen. Data sources included document analysis, the observation of exit level assessments, and individual and group interviews with faculty involved in exit level assessments. The audio-recorded interviews were transcribed and inductive thematic analysis was carried out. Data from documents were mapped on Excel spreadsheets and an observation schedule was used to collect data during observation of actual clinical assessments. Two analytical tools, Miller’s ‘pyramid’ (1990) and Disability Adjusted Life Years (DALYs), were then used for deductive analysis of data obtained from documents and observations. There were a number of findings of note. A selection of assessment methods were used at the three study sites. Although assessment question content was appropriate and focussed on relevant contextual health-related issues, the evidence gathered through current assessment practices is insufficient to allow accurate judgements to be made about the clinical competence of the students. DALYs as an analytical tool has the potential to contribute to a process of blueprinting, but its limitations in its use with the non-disease based curriculum have been highlighted. Examiners were key players involved in exit-level assessment and have considerable influence on assessment practices. However, their lack of understanding of the basic concept of assessment suggests a need for faculty development to raise the level of assessment literacy. The context within which assessment occurs and institutional cultures also influences assessment practices. This study has provided insights into exit level assessment practices taking place in a resource-constrained context such as Sub-Saharan Africa. It is envisaged that this research will add to the body of knowledge and that it will inform assessment practices going forward, as well as potentially informing curriculum design.
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    Mapping undergraduate exit-level assessment in a medical programme : a blueprint for clinical competence?
    (Health & Medical Publishing Group, 2016-05) Tan, Christina Phoay Lay; Van Schalkwyk, Susan Camille; Bezuidenhout, Juanita; Cilliers, Francois
    ENGLISH SUMMARY : Background. Assessment is an essential component of a medical curriculum. High-stakes exit-level assessment used for licensing and certification purposes needs to be sound. Even though criteria for evaluating assessment practices exist, an analysis of the nature of these practices is first required. Objective. To map current exit-level assessment practices, as described in institutional documentation. Methods. This descriptive interpretive study centred on the document analysis of final-phase study guides of the undergraduate medical programme at Stellenbosch University, Cape Town, South Africa. Results. The key findings were: (i) there is a diversity of methods and approaches to assessment in the final-phase modules; (ii) modules using similar assessment methods applied different credit weightings; (iii) similar assessment methods were described differently across the study guides; and (iv) study guides varied in the amount of information provided about the assessment methods. Conclusion. There is a diverse range of assessment practices at exit level of the MB,ChB programme at Stellenbosch University. This in-depth analysis of assessment methods has highlighted areas where current practice needs to be investigated in greater depth, and where shifts to a more coherent practice should be encouraged. Assessment mapping provides a useful reference for programme co-ordinators and is applicable to other programmes.