 |
|
CLINICIAN'S CORNER
Accuracy of Physician Self-assessment Compared With Observed Measures of Competence
A Systematic Review
David A. Davis, MD;
Paul E. Mazmanian, PhD;
Michael Fordis, MD;
R. Van Harrison, PhD;
Kevin E. Thorpe, MMath;
Laure Perrier, MEd, MLIS
JAMA. 2006;296:1094-1102.
Context Core physician activities of lifelong learning, continuing medical education credit, relicensure, specialty recertification, and clinical competence are linked to the abilities of physicians to assess their own learning needs and choose educational activities that meet these needs.
Objective To determine how accurately physicians self-assess compared with external observations of their competence.
Data Sources The electronic databases MEDLINE (1966-July 2006), EMBASE (1980-July 2006), CINAHL (1982-July 2006), PsycINFO (1967-July 2006), the Research and Development Resource Base in CME (1978-July 2006), and proprietary search engines were searched using terms related to self-directed learning, self-assessment, and self-reflection.
Study Selection Studies were included if they compared physicians' self-rated assessments with external observations, used quantifiable and replicable measures, included a study population of at least 50% practicing physicians, residents, or similar health professionals, and were conducted in the United Kingdom, Canada, United States, Australia, or New Zealand. Studies were excluded if they were comparisons of self-reports, studies of medical students, assessed physician beliefs about patient status, described the development of self-assessment measures, or were self-assessment programs of specialty societies. Studies conducted in the context of an educational or quality improvement intervention were included only if comparative data were obtained before the intervention.
Data Extraction Study population, content area and self-assessment domain of the study, methods used to measure the self-assessment of study participants and those used to measure their competence or performance, existence and use of statistical tests, study outcomes, and explanatory comparative data were extracted.
Data Synthesis The search yielded 725 articles, of which 17 met all inclusion criteria. The studies included a wide range of domains, comparisons, measures, and methodological rigor. Of the 20 comparisons between self- and external assessment, 13 demonstrated little, no, or an inverse relationship and 7 demonstrated positive associations. A number of studies found the worst accuracy in self-assessment among physicians who were the least skilled and those who were the most confident. These results are consistent with those found in other professions.
Conclusions While suboptimal in quality, the preponderance of evidence suggests that physicians have a limited ability to accurately self-assess. The processes currently used to undertake professional development and evaluate competence may need to focus more on external assessment.
Author Affiliations: Knowledge Translation Program of the Li Ka Shing Knowledge Institute at St Michael's Hospital (Dr Davis and Mr Thorpe), Departments of Health Policy, Management, and Evaluation (Dr Davis), Family and Community Medicine (Dr Davis), and Public Health Sciences (Mr Thorpe), and the Office of Continuing Education and Professional Development (Ms Perrier), University of Toronto, Toronto, Ontario; Departments of Family Medicine and Epidemiology and Community Health, School of Medicine, Virginia Commonwealth University, Richmond (Dr Mazmanian); Center for Collaborative and Interactive Technologies, Baylor College of Medicine, Houston, Tex (Dr Fordis); and Department of Medical Education, University of Michigan, Ann Arbor (Dr Harrison).
RELATED ARTICLE
Self-assessment in Lifelong Learning and Improving Performance in Practice: Physician Know Thyself
F. Daniel Duffy and Eric S. Holmboe
JAMA. 2006;296(9):1137-1139.
EXTRACT
| FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Predictors of Multivisceral Resection in Patients with Locally Advanced Colorectal Cancer
Govindarajan et al.
Ann. Surg. Oncol. 2008;15:1923-1930.
ABSTRACT
| FULL TEXT
The effectiveness of an educational programme on occupational disease reporting
Smits et al.
Occup Med (Lond) 2008;0:kqn061v1-kqn061.
ABSTRACT
| FULL TEXT
Problem based learning
Wood
BMJ 2008;336:971-971.
FULL TEXT
The ABPN Maintenance of Certification Program for Psychiatrists: Past History, Current Status, and Future Directions
Faulkner et al.
Acad. Psychiatry 2008;32:241-248.
ABSTRACT
| FULL TEXT
The self critical doctor: helping students become more reflective
Driessen et al.
BMJ 2008;336:827-830.
FULL TEXT
Lifelong learning at work
Teunissen and Dornan
BMJ 2008;336:667-669.
FULL TEXT
Invited article: Neurology education research
Stern et al.
Neurology 2008;70:876-883.
ABSTRACT
| FULL TEXT
Dental Students' Self-Assessment of Preclinical Examinations
Curtis et al.
J Dent Educ 2008;72:265-277.
ABSTRACT
| FULL TEXT
Using Self-Assessments to Detect Workshop Success: Do They Work?
D'Eon et al.
American Journal of Evaluation 2008;29:92-98.
ABSTRACT
Impact of Research-based Synopses Delivered as Daily E-mail: A Prospective Observational Study
Grad et al.
J. Am. Med. Inform. Assoc. 2008;15:240-245.
ABSTRACT
| FULL TEXT
Teaching when time is limited
Irby and Wilkerson
BMJ 2008;336:384-387.
FULL TEXT
Health staff perception regarding quality of delivered information to inpatients
Duclos et al.
Int J Qual Health Care 2008;20:13-21.
ABSTRACT
| FULL TEXT
The effects of problem-based learning during medical school on physician competency: a systematic review
Koh et al.
CMAJ 2008;178:34-41.
ABSTRACT
| FULL TEXT
Improving Asthma Care Through Recertification: A Cluster Randomized Trial
Simpkins et al.
Arch Intern Med 2007;167:2240-2248.
ABSTRACT
| FULL TEXT
Effectiveness of Teaching Quality Improvement to Clinicians: A Systematic Review
Boonyasai et al.
JAMA 2007;298:1023-1037.
ABSTRACT
| FULL TEXT
Translating learning into practice: Lessons from the practice-based small group learning program
Armson et al.
cfp 2007;53:1477-1485.
ABSTRACT
| FULL TEXT
Efficacy of Communication Skills Training for Giving Bad News and Discussing Transitions to Palliative Care
Back et al.
Arch Intern Med 2007;167:453-460.
ABSTRACT
| FULL TEXT
Sophia
Emerg. Med. J. 2007;24:70-70.
FULL TEXT
Self-assessment in lifelong learning and improving performance in practice: physician know thyself.
Duffy and Holmboe
JAMA 2006;296:1137-1139.
FULL TEXT
Medical education 2006: beyond mental mediocrity.
Golub
JAMA 2006;296:1139-1140.
FULL TEXT
|
