Understanding self-assessment as an informed process: residents’ use of external information for self-assessment of performance in simulated resuscitations
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Self-directed learning requires self-assessment of learning needs and performance, a complex process that requires collecting and interpreting data from various sources. Learners’ approaches to self-assessment likely vary depending on the learner and the context. The aim of this study was to gain insight into how learners process external information and apply their interpretation of this information to their self-assessment and learning during a structured educational activity. The study combined quantitative performance data with qualitative interview data. Pediatric residents led video-recorded simulated resuscitations and rated their crisis resource management skills on a validated 6-item instrument. Three independent observers rated the videos using the same instrument. During semi-structured interviews, each resident reviewed the video, rerated performance, discussed the self-assessment process, and interpreted feedback and observer scores. Transcripts were analyzed for themes. Sixteen residents participated. Residents’ self-assessed scores ranged widely but usually fell within two points of the observers. They almost universally lowered their scores when self-assessing after the video review. Five major themes emerged from qualitative analysis of their interviews: (1) residents found self-assessment important and useful in certain contexts and conditions; (2) residents varied in their self-directed learning behaviors after the simulated resuscitation; (3) quantitative observer assessment had limited usefulness; (4) video review was difficult but useful; and (5) residents focused on their weaknesses and felt a need for constructive feedback to enhance learning. The residents in our study almost uniformly embraced the importance of self-assessment for all medical professionals. Even though video review had a negative impact on their self-assessment scores and was perceived as painful, residents saw this as the most useful aspect of the study exercises residents. They were less accepting of the quantitative assessment by observers. Residents explained their tendency to focus on weaknesses as a way to create an incentive for learning, demonstrating that self-assessment is closely linked to self-directed learning. How learners can use video review and external assessment most effectively to guide their self-directed learning deserves further study.
KeywordsCrisis resource management skills Disconfirming feedback External assessment Informed self-assessment Self-directed learning Simulated resuscitation Video review
- ABMS. (2006). Maintenance of certification. Retrieved April 19, 2009, from http://www.abms.org/Maintenance_of_Certification/ABMS_MOC.aspx.
- ACGME. (2007). Common program requirements: General competencies. Retrieved April 16, 2009, from http://www.acgme.org/outcome/comp/GeneralCompetenciesStandards21307.pdf.
- Boyatzis, R. E. (1998). Transforming qualitative information: Thematic analysis and code development. Thousand Oaks: Sage Publications.Google Scholar
- Creswell, J. W., & Clark, V. L. P. (2011). Designing and conducting mixed methods research (2nd ed.). Thousand Oaks: Sage Publications.Google Scholar
- Gaba, D. M., Fish, K. J., & Howard, S. K. (1994). Crisis management in anesthesiology. New York: Churchill-Livingstone.Google Scholar
- Kim, J., Neilipovitz, D., Cardinal, P., Chiu, M., & Clinch, J. (2006). A pilot study using high-fidelity simulation to formally evaluate performance in the resuscitation of critically ill patients: The University of Ottawa Critical Care Medicine, High-Fidelity Simulation, and Crisis Resource Management I Study. Critical Care Medicine, 34(8), 2167–2174.CrossRefGoogle Scholar
- Parker, R. W., Alford, C., & Passmore, C. (2004). Can family medicine residents predict their performance on the in-training examination? Family Medicine, 36(10), 705–709.Google Scholar
- Patton, M. Q. (2002). Qualitative research and evaluation methods (3rd ed.). Thousand Oaks: Sage Publishers.Google Scholar
- Stemler, S. E., & Tsai, J. (2008). Best practices in interrater reliability: three common approaches. In J. Osborne (Ed.), Best practices in quantitative methods. Thousand Oaks: Sage Publications.Google Scholar
- Tuckman, B. W. (1999). Conducting educational research (5th ed.). New York: Harcourt Brace College Publishers.Google Scholar