Francois Cilliers

Background. Assessment research and practice remain dominated by Eurocentric paradigms that overlook contextual realities in the Global South. In these settings, assessment often occurs under colonial legacies and competing expectations of international comparability and local relevance. Objectives. To explore how a decolonial lens reinterprets how post-colonial contexts influence assessment practices in Southern settings, and how these may reflect, resist or negotiate ongoing coloniality in health professions education. Methods. A qualitative, interpretivist study was undertaken, and 33 lecturers responsible for undergraduate assessment were purposively recruited from four medical schools: two South African, one Mexican and one Namibian. Qualitative data from semi-structured interviews were analysed using reflexive thematic analysis and a decolonial lens to interpret post-colonial contextual influences on assessor practice.Results. Assessment practices reflected negotiated responses to local and global pressures in three ways: (i) assessment as contextual responsiveness, emphasising fairness and social accountability, aligning with decolonial orientations; (ii) assessment as global benchmarking, reflecting pressures linked to limited residency opportunities and international competitiveness; and (iii) assessment as negotiation under structural constraints, illustrating a ‘glocal’ (global-local) approach. Across contexts, assessment practices were shaped by ongoing negotiations between local relevance and global expectations. Conclusion. Assessment practices in the Global South are not simply decolonial or colonial but are dynamically negotiated within complex sociohistorical and structural conditions. A decolonial perspective highlights the need for contextual reflexivity in health professions education assessment design, supporting ‘glocalisation’ approaches that are both globally informed and locally responsive.

In many contexts, responsibility for exit-level assessment design and implementation in undergraduate medical programmes lies with individuals who convene clinical clerkships. Their assessment practice has significant consequences for students’ learning and the patients and communities that graduates will serve. Interventions to enhance assessment must involve these assessors, yet little is known about factors influencing their assessment practice. The purpose of this study was to explore factors that influence assessment practice of clerkship convenors in three varied low-and-middle income contexts in the global South. Taking assessment practice as a behaviour, Health Behaviour Theory (HBT) was deployed as a theoretical framework to explore, describe and explain assessor behaviour. Thirty-one clinician-educators responsible for designing and implementing high-stakes clerkship assessment were interviewed in South Africa and Mexico. Interacting personal and contextual factors influencing clinician-educator assessment intention and action were identified. These included attitude, influenced by impact and response appraisal, and perceived self-efficacy; along with interpersonal, physical and organisational, and distal contextual factors. Personal competencies and conducive environments supported intention to action transition. While previous research has typically explored factors in isolation, the HBT framing enabled a systematic and coherent account of assessor behaviour. These findings add a particular contextual perspective to understanding assessment practice, yet also resonate with and extend existing work that predominantly emanates from high-income contexts in the global North. These findings provide a foundation for the planning of assessment change initiatives, such as targeted, multi-factorial faculty development.

Article Citation: Francois J. Cilliers and Ara Tekian (2016) Effective Faculty Development in an Institutional Context: Designing for Transfer. Journal of Graduate Medical Education: May 2016, Vol. 8, No. 2, pp. 145-149. doi: http://dx.doi.org/10.4300/JGME-D-15-00117.1

Doctoral studies represent a complex undertaking for students and supervisors. Some research describes the experience of students while there are volumes of advice for students considering a doctorate. Yet the terrain for supervisors is less well-trodden and the concept of a pedagogy of supervision is only really starting to emerge. Texts on the doctoral journey from the supervisor’s perspective are uncommon and less yet has been written in the context of health professions education. The aim of this Guide, therefore, is to provide guidance for the supervisor’s journey, drawing on our collective experience and such literature as there is. We explore the doctoral journey of students and their supervisors, highlighting what the implications are for supervisory practice. Recognising the doctorate as much more than merely conducting a research project, and seeing it as a shared educational endeavour is fundamental to understanding the doctoral journey — a journey that is complex and mutable, constantly shifting as the candidate moves from novice to expert, from dependence to growing autonomy. Our intention is to present this Guide as a toolkit for both the novice and the experienced supervisor as it, on the one hand, seeks to make the practice of supervision more transparent while on the other, challenges the reader to critically reflect on the supervisory space in which they currently reside. Our hope is that the Guide opens up opportunities for generative conversations about the practice of doctoral supervision in health professions education.

Background. During curriculum revision, an important task is identifying a core curriculum. Deciding what criteria to use to determine core content is crucial and impacts on graduate outcomes and patient care. Objective. To identify criteria to apply in order to determine core content. Methods. A high engagement process involving eleven staff and two undergraduate student representatives was used. The process consisted of a stimulus question; brainstorming; sharing, clarification and clustering of ideas; second-phase brainstorming, clarification and clustering; prioritisation; and finally vote tally and categorisation. Results. The group initially identified 28 criteria to use when deciding on core content. The criteria were reduced stepwise to 15, and finally 3 criteria that enjoyed widespread support were identified. Content would be included in the curriculum if: (i) it was relevant to the South African context; (ii) it would ensure safe and effective practice by first-line practitioners; and (iii) it was evidence-based. Conclusion. The process lends itself to the participation of multiple stakeholders in an engaging yet anonymous manner. It helps ensure that all voices are heard and ideas included in prioritisation. The process easily manages a multiplicity of ideas; similar ideas are efficiently identified and clustered. Finally, the process is time-efficient.

There is a dire need to expand the capacity of institutions in Africa to educate health care professionals. Family physicians, as skilled all-rounders at district level, are potentially well placed to contribute to an extended training platform in this context. To play this role, they need to both have an understanding of their specialist role that incorporates teaching and be equipped for their role as trainers of current and future health workers and specialists. A teaching and learning capacity-building module was introduced into a new master’s programme in family medicine at Stellenbosch University, South Africa. We report on the influence of this module on graduates after the first six years.

Medical Education 2012: 46 : 1087–1098 OBJECTIVES  We previously developed a model of the pre‐assessment learning effects of consequential assessment and started to validate it. The model comprises assessment factors, mechanism factors and learning effects. The purpose of this study was to continue the validation process. For stringency, we focused on a subset of assessment factor–learning effect associations that featured least commonly in a baseline qualitative study. Our aims were to determine whether these uncommon associations were operational in a broader but similar population to that in which the model was initially derived. METHODS  A cross‐sectional survey of 361 senior medical students at one medical school was undertaken using a purpose‐made questionnaire based on a grounded theory and comprising pairs of written situational tests. In each pair, the manifestation of an assessment factor was varied. The frequencies at which learning effects were selected were compared for each item pair, using an adjusted alpha to assign significance. The frequencies at which mechanism factors were selected were calculated. RESULTS  There were significant differences in the learning effect selected between the two scenarios of an item pair for 13 of this subset of 21 uncommon associations, even when a p‐value of < 0.00625 was considered to indicate significance. Three mechanism factors were operational in most scenarios: agency; response efficacy, and response value. CONCLUSIONS  For a subset of uncommon associations in the model, the role of most assessment factor–learning effect associations and the mechanism factors involved were supported in a broader but similar population to that in which the model was derived. Although model validation is an ongoing process, these results move the model one step closer to the stage of usefully informing interventions. Results illustrate how factors not typically included in studies of the learning effects of assessment could confound the results of interventions aimed at using assessment to influence learning.