Mapping the evidence on public health competency assessment strategies in undergraduate medical education: a scoping review.
TL;DR
To map and characterise the scientific evidence on strategies used to assess public health competencies in undergraduate medical students, a continuum of evaluative complexity was identified, reflecting a shift from cognitive assessment towards multidimensional, context-based and performance-oriented approaches.
Abstract
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.