Enhancing Clinical Clerkship Assessment: A Framework Aligned with the National Core Curriculum

Abstract

Objective: To evaluate the effects of an innovative assessment framework for clinical clerkships aligned with the national core curriculum, aiming to enhance student-centered learning, interdisciplinary collaboration, and structured assessment practices. Methods: This study employs a qualitative document analysis educational research design, focusing on the evaluation of an innovative assessment framework for clinical clerkships. A structured assessment framework was designed and implemented in all clinical clerkships at the Karadeniz Technical University, Faculty of Medicine. The framework integrated multiple assessment methods—structured oral exams, workplace-based assessments, and learner-centered activities—ensuring their alignment with curriculum objectives derived from the national core curriculum. Results: The implementation of the framework resulted in a significant increase in the diversity of assessment methods between the 2020–2021 and 2023–2024 academic years. Previously, assessment relied heavily on multiple-choice exams. However, after implementation, structured oral exams, OSCEs, reflective writing, and workplace-based evaluations were widely incorporated. The integration of these methods improved the alignment of assessments with learning objectives and enhanced interdisciplinary collaboration in clinical education. Conclusion: This study highlights the successful adoption of an assessment framework that aligns with the national core curriculum while promoting structured and competency-based evaluation. The findings support the literature on the benefits of structured assessment tools in medical education. The framework serves as a model for medical schools aiming to improve their accreditation readiness and enhance student-centered learning. Future research should explore the long-term impact of this model on student competency and adaptability in various institutional settings.

Keywords

• Assessment
• Framework
• National core curriculum
• Clinical clerkship
• Accreditation.

References

1. Redwood-Campbell L, Pakes B, Rouleau K, et al. Developing a curriculum framework for global health in family medicine: emerging principles, competencies, and educational approaches. BMC Med Educ. 2011;11:46. doi:10.1186/1472-6920-11-46
2. Taber S, Akdemir N, Gorman L, van Zanten M, Frank JR. A "fit for purpose" framework for medical education accreditation system design. BMC Med Educ. 2020;20(Suppl 1):306. doi:10.1186/s12909-020-02122-4
3. Frank JR, Taber S, van Zanten M, Scheele F, Blouin D; International Health Professions Accreditation Outcomes Consortium. The role of accreditation in 21st century health professions education: report of an International Consensus Group. BMC Med Educ. 2020;20(Suppl 1):305. doi:10.1186/s12909-020-02121-5
4. Hauer KE, Park YS, Bullock JL, Tekian A. "My Assessments Are Biased!" Measurement and sociocultural approaches to achieve fairness in assessment in medical education. Acad Med. 2023;98(8S):S16-S27. doi:10.1097/ACM.0000000000005245
5. National Core Curriculum (UÇEP). 2020. Available from: https://www.yok.gov.tr/Documents/Kurumsal/egitim_ogretim_dairesi/Ulusal-cekirdekegitimi-programlari/mezuniyet-oncesi-tipegitimi-cekirdek-egitimi-programi.pdf. Accessed January 24, 2025.
6. Lockyer J, Carraccio C, Chan MK, et al. Core principles of assessment in competency-based medical education. Med Teach. 2017;39(6):609-616. doi:10.1080/0142159X.2017.1315082
7. Quintero GA. Medical education and the healthcare system - why does the curriculum need to be reformed?. BMC Med. 2014;12:213. doi:10.1186/s12916-014-0213-3
8. Harden RM. The integration ladder: a tool for curriculum planning and evaluation. Med Educ. 2000;34(7):551-557. doi:10.1046/j.1365-2923.2000.00697.x

9. Bowen GA. Document analysis as a qualitative research method. Qual Res J. 2009;9(2): 27-40.
10. Karadeniz Technical University University Faculty of Medicine. Self-evaluation report. 2024. Available from: https://www.ktu.edu.tr/dosyalar/med_8W7iq.pdf
11. Lucey CR, Hauer KE, Boatright D, Fernandez A. Medical education's wicked problem: achieving equity in assessment for medical learners. Acad Med. 2020;95(12S):S98-S108. doi:10.1097/ACM.0000000000003717
12. Tavakol M, Dennick R. The foundations of measurement and assessment in medical education. Med Teach. 2017;39(10):1010-1015. doi:10.1080/0142159X.2017.1359521
13. Lee GB, Chiu AM. Assessment and feedback methods in competency-based medical education. Ann Allergy Asthma Immunol. 2022;128(3):256-262. doi:10.1016/j.anai.2021.12.010
14. Dawson SD, Miller T, Goddard SF, Miller LM. Impact of outcome-based assessment on student learning and faculty instructional practices. J Vet Med Educ. 2013;40(2):128-138. doi:10.3138/jvme.1112-100R
15. Lakhtakia R, Otaki F, Alsuwaidi L, Zary N. Assessment as learning in medical education: feasibility and perceived impact of student-generated formative assessments. JMIR Med Educ. 2022;8(3):e35820. doi:10.2196/35820
16. Beltran CP, Wilhite JA, Gonzalez CM, et al. Requested a Different Doctor: Developing and Evaluating an OSCE Assessing Core Skills in Supporting Trainees Facing Patient Discrimination. J Gen Intern Med. 2025;40(1):207-212. doi:10.1007/s11606-024-09021-0
17. Ba H, Zhang L, He X, Li S. Knowledge Mapping and Global Trends in the Field of the Objective Structured Clinical Examination: Bibliometric and Visual Analysis (2004-2023). JMIR Med Educ. 2024;10:e57772. Published 2024 Sep 30. doi:10.2196/57772
18. Foy JP, Serresse L, Decavèle M, et al. Clues for improvement of research in objective structured clinical examination. Med Educ Online. 2024;29(1):2370617. doi:10.1080/10872981.2024.2370617
19. Abuzied AIH, Nabag WOM. Structured viva validity, reliability, and acceptability as an assessment tool in health professions education: a systematic review and meta-analysis. BMC Med Educ. 2023;23(1):531. Published 2023 Jul 25. doi:10.1186/s12909-023-04524-6
20. Pearce J, Edwards D, Fraillon J, Coates H, Canny BJ, Wilkinson D. The rationale for and use of assessment frameworks: improving assessment and reporting quality in medical education. Perspect Med Educ. 2015;4(3):110-118. doi:10.1007/s40037-015-0182-z
21. Mukurunge E, Nyoni CN, Hugo L. Context of assessment in competency-based nursing education: Semi-structured interviews in nursing education institutions in a low-income country. Nurse Educ Today. 2025;146:106529. doi:10.1016/j.nedt.2024.106529
22. Ladhani Z, Scherpbier AJ, Stevens FC. Competencies for undergraduate community-based education for the health professions--a systematic review. Med Teach. 2012;34(9):733-743. doi:10.3109/0142159X.2012.700742
23. Alharbi NS. Evaluating competency-based medical education: a systematized review of current practices. BMC Med Educ. 2024;24(1):612. Published 2024 Jun 3. doi:10.1186/s12909-024-05609-6
24. Skochelak SE, Lomis KD, Andrews JS, Hammoud MM, Mejicano GC, Byerley J. Realizing the vision of the Lancet Commission on Education of Health Professionals for the 21st Century: Transforming medical education through the Accelerating Change in Medical Education Consortium. Med Teach. 2021;43(sup2):S1-S6. doi:10.1080/0142159X.2021.1935833