Background
The increasing complexity of health systems and the growing importance of social determinants of health require physicians trained with a population-based perspective. However, assessment of public health competencies in undergraduate medical education remains heterogeneous, with limited conceptual integration and lack of standardised approaches.
Objective
To map and characterise the scientific evidence on strategies used to assess public health competencies in undergraduate medical students.
Methods
A scoping review was conducted following Joanna Briggs Institute methodology and reported according to PRISMA-ScR guidelines. A systematic search was performed in PubMed, Scopus, LILACS and IEEE Xplore for studies published between January 2011 and January 2026. Studies involving undergraduate medical students and addressing assessment of public health competencies were included. Data were extracted using a structured matrix and synthesised narratively.
Results
Thirty studies were included, demonstrating marked heterogeneity across study designs, including randomised controlled trials, observational, qualitative and mixed-methods studies. Assessment strategies were organised into key domains, ranging from knowledge-based evaluations to performance-based approaches in authentic settings. Experiential strategies, such as community-based learning and service learning, enabled integration of social determinants of health into assessment processes. A continuum of evaluative complexity was identified, reflecting a shift from cognitive assessment towards multidimensional, context-based and performance-oriented approaches. Most studies were conducted in high-income countries.
Conclusions
Assessment of public health competencies is evolving towards integrated, contextualised and performance-based models. However, the absence of standardised frameworks and validated instruments limits comparability across studies. Advancing towards longitudinal and programmatic assessment models is essential to strengthen medical training and align it with contemporary population health challenges.
Mapping the evidence on public health competency assessment strategies in undergraduate medical education: a scoping review. BMC Med Educ. 2026. doi:10.1186/s12909-026-09976-0.
García Dieguez M. Comment on the Mapping the evidence on public health competency assessment strategies in undergraduate medical education: a scoping review. [Internet]. Pan American Health Organization. Bibliographic Repository. Available at: https://campus.paho.org/en/repo/mapping-evidence-public-health-competency-assessment-strategies-undergraduate-medical
García Dieguez M.
CEEProS Universidad Nacional del Sur
This scoping review is particularly useful for educators, curriculum leaders, and assessment teams interested in evaluating public health competencies in undergraduate medical education. Rather than focusing solely on epidemiological knowledge, the article demonstrates how assessment is evolving toward models that integrate learner performance, community engagement, social determinants of health, and clinical practice in authentic settings. It also provides a clear classification of available assessment strategies and proposes a continuum of assessment complexity that can guide the redesign of competency-based assessment programs.
The authors describe a transition from assessment models focused primarily on knowledge acquisition to approaches that evaluate performance in authentic contexts. The most frequently reported strategies include service-learning, community-based projects, public health clerkships, simulation (OSCE), assessment using validated tools for social determinants of health, online collaborative activities, and longitudinal programmatic assessment. One of the article’s main contributions is the organization of these strategies into a continuum of ten levels of assessment complexity, ranging from written examinations to longitudinal programmatic assessment and international consensus frameworks. It also proposes a structural typology linking each assessment method to the competency being assessed and the educational context in which it is most appropriate.
The review included 30 studies published between 2014 and 2025, identified through a systematic search conducted according to the Joanna Briggs Institute methodology and the PRISMA-ScR guidelines. The evidence showed substantial methodological heterogeneity and a strong concentration of studies from high-income countries, particularly the United States. The authors acknowledge important limitations, including heterogeneous study designs, the lack of internationally standardized assessment instruments, the predominance of research from high-income settings, and the absence of studies from Latin America and Africa, all of which limit comparisons across programs and the generalizability of the findings.
- Combine written examinations with authentic learning experiences such as community projects, service-learning, and public health clerkships.
- Explicitly assess competencies related to social determinants of health, equity, and social accountability using rubrics or validated instruments.
- Use OSCEs, standardized patients, and simulation to assess communication skills, health promotion, and health literacy.
- Implement longitudinal assessment strategies that document progressive competency development through portfolios and multiple sources of evidence.
- Incorporate digital modalities (e-learning and virtual collaborative learning) when assessing competencies in intercultural or geographically distributed settings.
- Design programmatic assessment systems that combine multiple assessment methods, time points, and learning contexts rather than relying on a single final examination.