Quality assessment in undergraduate medical training: how to bridge the gap between what we do and what we should do

Introduction: the outcome of the undergraduate medical training programme in South Africa is to produce competent medical doctors who can integrate knowledge, skills and attitudes relevant to the South African context. Training facilities have a responsibility to ensure that they perform this assessment of competence effectively and defend the results of high-stakes assessments. This study aimed to obtain qualitative data to suggest practical recommendations on best assessment practices to address the gaps between theoretical principles that inform assessment and current assessment practices. Methods: a focus group interview was used to gather this data. The teaching and learning coordinators for five of the six modules that are offered in the clinical phase of the undergraduate medical programme participated in the focus group interview. The focus group interview proceeded as planned and took 95 minutes to complete. The responses were transcribed and recorded on a matrix. Results: the lack of formal feedback to students was identified as an area of concern; feedback plays an important role to promote student learning and improve patient care. The role of teaching and learning coordinators as drivers of quality assessment were recognized and supported. All participants agreed on the outcome of the programme and the central role of the outcome in all assessments. Conclusion: the training of assessors and the implementation of workplace-based assessment and assessment portfolios were recommended and can also address feasibility challenges. Participants recommended decreasing summative assessments and only performing these for borderline students.