Myth or Reality: Self-Assessment Is Central to Effective Curriculum in Anatomical Pathology Graduate Medical Education

Abstract

Self-assessment, a personal evaluation of one’s professional attributes and abilities against a perceived norm, has frequently been cited as a necessary component of self-directed learning and the maintenance of competency within regulated health professions, including the medical professions. However, education research literature has consistently shown uninformed personal global assessment of performance to be inaccurate in a variety of contexts, and have limited value in a workplace-based curriculum. Incorporating known standards of performance with internal and external data on the performance improves a learner’s ability to accurately self-assess. Selecting content suitable for self-assessment, providing explicit assessment standards, encouraging feedback-seeking behaviors, supporting a growth mindset, and providing quality feedback in a supportive context are all strategies that can support learner self-assessment, learner engagement in reflection, and action on feedback in Anatomical Pathology graduate medical education.

Behavioral skills training for teaching safety skills to mental health service providers compared to training-as-usual: a pragmatic randomized control trial

“…Our finding of a differential impact of training on confidence versus demonstrable skills is consistent with a long-standing, substantial body of research examining the relationship between self-assessment and objective measures of learning [ 28 , 65 , 66 ]. The pattern of non-existent, weak, or even inverse relationships between the two has been shown for a variety of medical staff trainee and education learner groups [ 28 , 29 , 67 – 72 ].…”

“…Yates et al [ 65 ] suggest that ease of collecting this information is a factor. More complex and nuanced explanations are offered by Lu, et al [ 66 ] and Tavares, et al [ 73 ] who note that self-assessment is an important component in theories of learning and evaluation and that self-perception and self-reflection (particularly when objective findings are shared) are critical ingredients for supporting medical and continuing profession education in a self-regulating profession.…”

Regulating in the public interest: Lessons learned during the COVID-19 pandemic

“…24 Health professionals in independent practice, such as physicians, are responsible for determining and assessing their competency and learning needs 32 despite some evidence suggesting consistent inaccuracies with "personal global assessments of performance…in a variety of contexts." 33 When regulators or employers place this expectation on practitioners without sufficient guidance, practitioners may feel unsupported and experience additional stress in daily practice, 13 especially during an unprecedented, unsettled global event that has adversely impacted the health workforce. [34][35][36][37] Moreover, empirical studies indicate accurate self-assessment of competence is unreliable in particular contexts.…”

“…[34][35][36][37] Moreover, empirical studies indicate accurate self-assessment of competence is unreliable in particular contexts. 33 Furthermore, pressure on practitioners is amplified if they are expected to be reactive to guidance or directives that continue to change and to make informed (scope of) practice choices with insufficient time to consider their competence and self-efficacy. 24 This predicament can also compromise quality care, safe practice and patient safety, thus providing less protection for both practitioners and patients.…”

Behavioral skills training for teaching safety skills to mental health service providers compared to training-as-usual: a pragmatic randomized control trial

“…It may also be that the measurement method is an important factor. Self-assessment, for example, has been consistently found to be an imperfect measure of actual performance or knowledge (57,58). Whether or not attitudes and con dence contribute positively in ways that are independent of actual skills or negatively in that they provide an inappropriate sense of competence merits exploration.…”