The introduction of workplace-based assessment for general surgery training at a South African university

dc.contributor.advisorJonas, Eduard
dc.contributor.advisorBurch, Vanessa
dc.contributor.advisorCaincross, Lydia
dc.contributor.authorNel, Daniel
dc.date.accessioned2026-01-19T08:30:15Z
dc.date.available2026-01-19T08:30:15Z
dc.date.issued2025
dc.date.updated2026-01-19T08:27:32Z
dc.description.abstractAssessment in postgraduate training in South Africa has traditionally focused solely on knowledge objectives. There is currently a movement to introduce Workplace-Based Assessment (WBA) to evaluate trainee clinical competence. However, concerns have been raised regarding the feasibility of this approach in a South African context. Similar concerns about feasibility and other issues with WBA implementation have been identified in General surgery in different settings. The aim of this study was to determine if it was possible to introduce WBA and to identify the characteristics of a WBA strategy that would ensure successful implementation at a South African university. Methods: The design-based research methodology was used to define the educational problem, generate guiding principles for a solution, test the solution through cycles of implementation and refinement, and finally reflect on the implementation process to derive a final set of design principles. The study was conducted in the Division of General Surgery at the University of Cape Town from 2022 to 2023. The planning of the design and the interpretation of the findings were considered in the context of socio-cultural learning theory. Results: Fifteen guiding principles, underpinned by theory, were used to design the WBA strategy. Three cycles of testing and refinement showed relatively high perceived feasibility, acceptability, and appropriateness among trainees and supervisors. The lessons learned from each cycle enabled the solution and design principles to be modified, in consultation with a stakeholder team, to further enhance participant perceptions and implementation. This process resulted in 15 final design principles, of which six were substantive and nine were procedural. The substantive principles related to the selection of EPAs, assessment tools, the supervisor base, and the digital platform. The procedural principles related to the pace of introduction, team development, managing the formative-summative tension, and change management approach. Conclusion: WBA can be introduced for postgraduate General surgery training at a South African university. Design principles have been identified to ensure a feasible introduction in this context. These principles may assist others in implementing new or refining existing WBA strategies.
dc.identifier.apacitationNel, D. (2025). <i>The introduction of workplace-based assessment for general surgery training at a South African university</i>. (). University of Cape Town ,Faculty of Health Sciences ,Division of General Surgery. Retrieved from http://hdl.handle.net/11427/42602en_ZA
dc.identifier.chicagocitationNel, Daniel. <i>"The introduction of workplace-based assessment for general surgery training at a South African university."</i> ., University of Cape Town ,Faculty of Health Sciences ,Division of General Surgery, 2025. http://hdl.handle.net/11427/42602en_ZA
dc.identifier.citationNel, D. 2025. The introduction of workplace-based assessment for general surgery training at a South African university. . University of Cape Town ,Faculty of Health Sciences ,Division of General Surgery. http://hdl.handle.net/11427/42602en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Nel, Daniel AB - Assessment in postgraduate training in South Africa has traditionally focused solely on knowledge objectives. There is currently a movement to introduce Workplace-Based Assessment (WBA) to evaluate trainee clinical competence. However, concerns have been raised regarding the feasibility of this approach in a South African context. Similar concerns about feasibility and other issues with WBA implementation have been identified in General surgery in different settings. The aim of this study was to determine if it was possible to introduce WBA and to identify the characteristics of a WBA strategy that would ensure successful implementation at a South African university. Methods: The design-based research methodology was used to define the educational problem, generate guiding principles for a solution, test the solution through cycles of implementation and refinement, and finally reflect on the implementation process to derive a final set of design principles. The study was conducted in the Division of General Surgery at the University of Cape Town from 2022 to 2023. The planning of the design and the interpretation of the findings were considered in the context of socio-cultural learning theory. Results: Fifteen guiding principles, underpinned by theory, were used to design the WBA strategy. Three cycles of testing and refinement showed relatively high perceived feasibility, acceptability, and appropriateness among trainees and supervisors. The lessons learned from each cycle enabled the solution and design principles to be modified, in consultation with a stakeholder team, to further enhance participant perceptions and implementation. This process resulted in 15 final design principles, of which six were substantive and nine were procedural. The substantive principles related to the selection of EPAs, assessment tools, the supervisor base, and the digital platform. The procedural principles related to the pace of introduction, team development, managing the formative-summative tension, and change management approach. Conclusion: WBA can be introduced for postgraduate General surgery training at a South African university. Design principles have been identified to ensure a feasible introduction in this context. These principles may assist others in implementing new or refining existing WBA strategies. DA - 2025 DB - OpenUCT DP - University of Cape Town KW - Workplace-Based Assessment KW - South Africa LK - https://open.uct.ac.za PB - University of Cape Town PY - 2025 T1 - The introduction of workplace-based assessment for general surgery training at a South African university TI - The introduction of workplace-based assessment for general surgery training at a South African university UR - http://hdl.handle.net/11427/42602 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/42602
dc.identifier.vancouvercitationNel D. The introduction of workplace-based assessment for general surgery training at a South African university. []. University of Cape Town ,Faculty of Health Sciences ,Division of General Surgery, 2025 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/42602en_ZA
dc.language.isoen
dc.language.rfc3066eng
dc.publisher.departmentDivision of General Surgery
dc.publisher.facultyFaculty of Health Sciences
dc.publisher.institutionUniversity of Cape Town
dc.subjectWorkplace-Based Assessment
dc.subjectSouth Africa
dc.titleThe introduction of workplace-based assessment for general surgery training at a South African university
dc.typeThesis / Dissertation
dc.type.qualificationlevelDoctoral
dc.type.qualificationlevelPhD
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