Context of assessment in competency-based nursing education: Semi-structured interviews in nursing education institutions in a low-income country.

Organisational considerations are essential when proposing the implementation of an educational innovation like programmatic assessment. Currently, most recommendations by regulatory bodies to adopt curriculum reforms do not take into consideration the characteristics and context of low-income countries. This paper explores the contexts of four nursing education institutions in a low-income country that recently adopted the programmatic assessment approach in their programmes. The study was underpinned by the environment phase of the Design Science Research framework and used semi-structured interviews to collect data. Deductive thematic analysis was performed to map the data to three themes: the people; the organisation in terms of culture, structure and strategies; and the state of technology. The results revealed that organisational contexts in terms of the people, the organisation culture, structure and strategies and the state of its technology are essential in the implementation of programmatic assessment. Successful implementation requires a shift in organisational paradigms in terms of assessment cultures while affording maximal support and education to enhance the capabilities of students and educators experiencing the change. Collaboration with other institutions at advanced stages of programmatic assessment implementation is essential. Finally, continuous professional development for all stakeholders is essential for sustainable implementation of the programmatic assessment approach.