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Diagnostic instruments in extended curriculum programs: a scoping review
Lunelle Pienaar1, Gaironeesa Hendricks1, Elmi Badenhorst1
1Department of Health Sciences Education, Faculty of Health Sciences, University of Cape Town, Western Cape, South Africa.
Abstract:
This study maps and synthesizes the existing body of literature on diagnostic tools and tests used within extended curriculum programs (ECPs) in higher education. Diagnostic assessment plays an important role in informing admission, placement, and early academic support within ECPs. The evidence based on the types, uses, and quality of diagnostic instruments, particularly within the South African higher education system, remains fragmented. This scoping review was conducted in accordance with the Arksey and O'Malley framework, as refined by Levac et al. (Levac D, Colquhoun H, O'Brien KK. Implement Sci 5: 69, 2010). Five electronic databases were systematically searched for empirical studies published between 2017 and 2025. Studies examining diagnostic assessment instruments used for admission, placement, or academic support in higher education were eligible for inclusion. Nine empirical studies met the inclusion criteria. Quantitative designs were utilized eight times (n = 8; 88.88%), representing diverse regions of the world. Three studies (33.33%) focused explicitly on health sciences education, primarily within medical training contexts. Diagnostic instruments commonly assessed cognitive or discipline-specific knowledge, as well as academic literacy or language proficiency. Diagnostic scores were predominantly used to predict how prepared students are for higher education or identify students at risk of academic difficulty. Only one study focused explicitly on ECP students. Evidence supporting the validity and reliability of diagnostic instruments was inconsistently reported, and limited attention was given to fairness, cultural responsiveness, and contextual relevance. The study findings highlight the need for validated ECP-specific diagnostic tools to support equitable student success.NEW & NOTEWORTHY We propose a framework for diagnostic instrument development that incorporates cultural appropriateness, to ensure that the instrument respects and aligns with cultural norms; contextual relevance, ensuring that the instrument is suitable for specific situations; persistence, which evaluates students' ability to continue despite challenges; psychosocial skills, which assesses social and emotional competencies; life skills, which measures practical abilities needed for daily life; content knowledge, which evaluates understanding of specific subjects; and cognitive abilities, which assesses cognitive abilities.
