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Assessment approaches in undergraduate health professions education: towards the development of feasible assessment approaches for low-resource settings

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Mukurunge, Eva, Nyoni, Champion N., Hugo, Lizemari·2024·BMC Medical Education
DOI 10.1186/s12909-024-05264-xPMC PMC10956342

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Abstract

Background: Feasible and effective assessment approaches to measuring competency in health sciences are vital in competency-based education. Educational programmes for health professions in low- and middle-income countries are increasingly adopting competency-based education as a strategy for training health professionals. Importantly, the organisation of assessments and assessment approaches must align with the available resources and still result in the fidelity of implementation. A review of existing assessment approaches, frameworks, models, and methods is essential for the development of feasible and effective assessment approaches in low-resource settings. Methods: Published literature was sourced from 13 electronic databases. The inclusion criteria were literature published in English between 2000 and 2022 about assessment approaches to measuring competency in health science professions. Specific data relating to the aims of each study, its location, population, research design, assessment approaches (including the outcome of implementing such approaches), frameworks, models, and methods were extracted from the included literature. The data were analysed through a multi-step process that integrated quantitative and qualitative approaches. Results: Many articles were from the United States and Australia and reported on the development of assessment models. Most of the articles included undergraduate medical or nursing students. A variety of models, theories, and frameworks were reported and included the Ideal model, Predictive Learning Assessment model, Amalgamated Student Assessment in Practice (ASAP) model, Leadership Outcome Assessment (LOA) model, Reporter-Interpreter-Manager-Educator (RIME) framework, the Quarter model, and the model which incorporates four assessment methods which are Triple Jump Test, Essay incorporating critical thinking questions, Multistation Integrated Practical Examination, and Multiple Choice Questions (TEMM) model. Additional models and frameworks that were used include the Entrustable Professional Activities framework, the System of Assessment framework, the Reporter-Interpreter-Manager-Educator (RIME) framework, the Clinical Reasoning framework (which is embedded in the Amalgamated Student Assessment in Practice (ASAP) model), Earl’s Model of Learning, an assessment framework based on the Bayer–Fetzer Kalamazoo Consensus Statement, Bloom's taxonomy, the Canadian Medical Education Directions for Specialists (CanMEDS) Framework, the Accreditation Council for Graduate Medical Education (ACGME) framework, the Dreyfus Developmental Framework, and Miller's Pyramid. Conclusion: An analysis of the assessment approaches, frameworks, models, and methods applied in health professions education lays the foundation for the development of feasible and effective assessment approaches in low-resource settings that integrate competency-based education. Trial registration: This study did not involve any clinical intervention. Therefore, trial registration was not required.

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  • Challenges of OSCE delivery are particularly pronounced in low- and middle-income countries, where constrained educational budgets, faculty shortages, and limited access to trained SPs hinder the sustainable delivery of OSCE-based education.

    “Such challenges are particularly pronounced in low- and middle-income countries (LMICs), where constrained educational budgets, faculty shortages, and limited access to trained SPs hinder the sustainable delivery of OSCE-based education.”

    From Development and Validation of CPX-MATE: An End-to-End Medical Education Platform Integrating Voice-Based Virtual Patient Simulation and Automated Real-time Evaluation (2026) · cites this paper as [5]

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  • Most studies compare isolated technologies or media without a unifying theoretical framework, leaving interventions to target only fragments of competence.

    “most studies compare isolated technologies or media without a unifying theoretical framework, leaving interventions to target only fragments of competence (8)”

    From Application effect of Miller’s pyramid teaching method based on HeartCode BLS in basic life support training for nursing students (2026) · cites this paper as [8]

    The Results section on components of a feasible assessment approach describes analytic, developmental, and holistic assessment frameworks. Searches for technology or media comparisons, a lack of unifying theory, and interventions targeting fragments of competence found no passage making the cited claim. No page numbers were available in our copy. (LLM, conf=0.76)

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Research works printed but not linked: 1

  1. [41]van der Vlueten CPM Heeneman S On the isuue of costs in programmatic assessment Prospective Medical Education 2016 1 2016 1 5 PMC5035281 27638392

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Authors
Mukurunge, E., Nyoni, C. N., & Hugo, L.
Affiliations
University of the Free State (ZA)
Corresponding author
Mukurunge, Eva
ORCID
Venue
BMC Medical Education
Publisher
Springer Science and Business Media LLC
Published
2024-03-20
Volume
24
Issue
1
Pages
318-318
ISSN
1472-6920 (ISSN-L)
DOI
10.1186/s12909-024-05264-x
PMC
PMC10956342
OpenAlex
W4392990370
Cited by
16
References
47
Citations by year
2026: 6 · 2025: 8 · 2024: 2
FWCI
6.53
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Medical Education (publishedVersion, cc-by)
  • Research Square (acceptedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Fetzer Institute
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
  • Health Sciences › Health Professions › General Health Professions › Health and Medical Education
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Medical Education and Admissions
Keywords
assessment methods, competency-based education, undergraduate health professions education, resource-limited settings, evaluation framework, evaluation model, competency assessment, medical education, nursing education, entrustable professional activities, clinical reasoning, low- and middle-income countries, CanMEDS framework, Miller's pyramid, Bloom's taxonomy
MeSH terms
Canada, Health Occupations, Health Personnel, Humans, Learning, Students

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