Quality assurance: A document review of moderation reports on final theoretical assessments

Background: Ensuring assessment quality in nursing education is crucial for preparing graduates for healthcare demands, particularly in South Africa, where healthcare systems face challenges. Moderation serves as a quality assurance tool, yet its effectiveness remains underexplored. Aim: To review moderation reports on final theoretical assessments of nursing modules in the R425 Bachelor of Nursing programme. Setting: A higher education institution (HEI) in the Western Cape, South Africa. Methods: A qualitative exploratory descriptive study analysed 70 moderation reports (2015–2019) using a structured data extraction tool and content analysis. Results: One main theme emerged, quality assurance in assessment design, with five categories: standard of questions and alignment with Bloom’s Taxonomy and NQF levels; linguistic presentation and clarity of questions; clarity of instructions to students; duration and mark allocation; and attainment of module outcomes. Conclusion: The study revealed persistent gaps in assessment quality, including misalignment with cognitive levels, unclear instructions, inconsistent mark allocation, and limited outcome alignment. These findings reinforce the need for robust moderation processes to support fair, valid, and reliable assessments. Recommendations include strengthening assessor training, implementing structured moderation frameworks, and improving documentation. Contribution: This study highlights the critical role of quality assurance in final theoretical assessments by identifying recurring issues in assessment design and moderation. It offers practical insights to enhance assessment integrity and ensure alignment with educational standards.