Article

Self‐evaluation by first‐year medical students in a clinical science programme

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Abstract

Medical student self evaluation in 1st yr clinical science emphasizes individual student appraisal of progress, confirmed and supplemented by tutors. Twice a year students evaluate their performance in areas such as interpersonal relations, professional conduct, and a sense of responsibility, and discuss these evaluations at individual student tutor conferences. Results of a study exploring the value of the self evaluation experiences and their contribution to professional development indicate that most students consider the approach worth while and that it influences their subsequent behaviour.

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... Individuals may be threatened by self-assessment, so establishing an open and trusting environment is essential to its success. Kennell et al. (1973) report that medical school teachers who took part in a self-assessment program to improve awareness of their own and others' teaching styles felt vulnerable to course leaders' criticisms, because they were not convinced of their neutrality. Some learners wrote scathing letters or refused to participate. ...
... Feedback from participants in self-assessment programs has generally been positive. Kennell et al. (1973, cited in Gordon 1992 followed medical students for two years to assess the influence of a self-assessment program. The students attributed attitudinal and behavioral changes to their selfassessment experience. ...
... 1 In medical education, self-awareness is considered a core competency and has been widely investigated. [1][2][3][4][5][6][7] For medical students, self-awareness can affect their health and development of clinical skills, 8 both of which can affect future patient care. Studies have investigated ways to increase self-awareness in students. ...
Article
Context: Self-awareness is vital for the health and development of medical students, but few reported modalities successfully increase medical student self-awareness. Objective: To assess the effect of ultrasonography on medical student self-awareness and health status. Methods: In 2016, first- and second-year osteopathic medical students completed a 9-item survey, created specifically for the current study, which included questions about the use of ultrasonography, health status, and self-awareness after completing at least 1 ultrasonography course. Differences between student responses by class were analyzed using χ2 analysis for items assessing experience with ultrasonography and t tests for items assessing self-awareness. Results: Of the 329 students surveyed, 192 (58.4%) reported using ultrasonography to explore or monitor their own health or body. Forty-nine students (14.9%) found out something about their health that they did not know before their exposure to ultrasonography. Significant differences were found in the use of ultrasonography between first-year and second-year students; more second-year students reported using ultrasonography outside of laboratory hours (P<.05) and discovering incidental findings (P<.05). The largest portions of students reported average health status for exercise (106 of 325 [32.6%]), stress management (174 of 324 [53.7%]), and sleep (137 of 326 [42.0%]). The largest portions of students reported very good health status for tobacco use (282 of 322 [87.6%]), alcohol use (138 of 323 [42.7%]), and healthy relationships (118 of 326 [36.2%]). Statistically significant differences existed in responses between first- and second-year students regarding exercise (P=.007) and alcohol use (P=.001). The majority of students agreed or strongly agreed (182 of 326 [55.8%]) that access to ultrasonography equipment and ultrasonography training during the first and second years of medical school increased their self-awareness. Conclusions: The results suggest that the incorporation of ultrasonography into medical education could potentially increase medical student health status and self-awareness.
... A n important goal of medical education is to provide the physician with the knowledge and skills required for life-long professional development. A critical skill in this regard is the ability to monitor and assess one's personal performance (Gordon, 1997;Kennell, Tempio, & Marcia, 1973). After all, in our current medical education process, once formal training is completed, further professional development is predicated on the clinician's ability to recognize his or her areas of weakness and take appropriate measures to remedy deficiencies. ...
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Peer and self-evaluation are crucial in the professional development of physicians. However, these skills must be learned, and there are barriers to their acceptance and successful utilization. To overcome these obstacles, it has been suggested that these concepts should be addressed longitudinally throughout medical education. Therefore, first-year medical students were introduced to peer and self-assessment as part of a videotape review during an interviewing course by having students complete written peer and self-assessments of the interviews. Students' self-assessments were compared with the assessments of peers and faculty. Written evaluations showed peers were more lenient than faculty and students were most critical of their own performances. Students could provide balanced assessments of their peers but were predominately negative regarding their own performances. It appears first-year students are capable of evaluating their peers but have difficulty accurately assessing their own performance. Further interventions are needed to foster self-assessment skills in first-year students.
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A study was conducted to determine whether, as the result of clinical experience in the third year of medical school and feedback on their performance from instructors, students would be able to perceive their areas of weakness, improve performance, and develop a perception of their performance that increasingly conformed to how faculty perceived them. Students evaluated their own performance in each rotation and compared their ratings with faculty ratings of them, using the same 16-item evaluation checklist. Students tended to rate themselves higher on all factors than the faculty rated them. Both faculty and students tended to give higher ratings in successive rotations, but changes in students' ratings were approximately twice those of faculty members from the first to last rotations. Students' perceptions of their performance seemed most subject to change in the areas of knowledge and management skills.
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Although expected of all health professionals, self-assessment skills are seldom addressed directly in training. A previous review by the author identified curricular criteria associated with improved accuracy and validity in self-assessments of knowledge and performance in curriculum studies published between January 1970 and February 1990. The present review analyzed 11 studies that meet those criteria. Eight studies were of implementations of self-assessment components within training programs in the health professions, and three involved other training environments. Most described initial disorientation or opposition on the part of learners, attributed to unfamiliar roles and to learners' distrust. The curricula that successfully negotiated the transition to self-assessment norms reported noncognitive benefits such as improvements in morale, motivation, and communications among learners and faculty. Reported cognitive benefits included improvements in knowledge, performance, and self-analysis of performance. The constellation of effects suggests that effective self-assessment programs may promote more mature, collegial, and productive learning environments, particularly suited to the training of health professionals. Most curricula fostering effective self-assessment did not require extraordinary resources, and none jeopardized traditional standards. No evidence was found to support or challenge the expectation that self-assessment training would transfer to later work settings.
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The knowledge and clinical and minor surgical skills acquired by 257 medical students in three universities in Sri Lanka and Malaysia were assessed by a questionnaire after they had completed their training period in ophthalmology. This study showed that many medical students graduating from these universities lacked the basic clinical and minor surgical skills essential for a doctor practising in a community in south-east Asia. The responses also indicated that teaching by consultants in all three universities was inadequate and due to these inadequacies the students requested that the duration of their training period be doubled. Ophthalmology is an important component of clinical practice and proper education in this subject is important. An urgent revision of the aims and objectives of the curriculum in ophthalmology is essential to place greater emphasis on this important and much neglected subject, for which very little curricular time is allotted.
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Research was carried out into the effectiveness of an innovative, problem-based introductory course which was designed to help medical students, within a traditional curriculum, to bridge the gap between theoretical study during the first 4 years and inservice training during the next 2 years. Comparison of exit and entry self-assessment ratings of students showed a marked rise for history-taking and physical examination and a smaller rise for diagnosis and patient management. Cross-study of these self-assessment ratings and the background variable of past medical training showed that prior active experience within the health care system appeared to have a favourable influence on both history-taking and more intellectual skills, notably diagnosis and patient management. History-taking, however, could be taught as effectively during the introductory course. This was not so for the more intellectual skills. The results of this research plead for early active experience within the health care system during the medical curriculum, in order to give the students more insight into the clinical relevance of their theoretical studies. Evaluation by the students of the teaching formats used to reach the learning objectives was favourable, especially of those formats related to concrete practical skills such as live simulated (programmed) patients. It was rather unfavourable to self-study facilities which provide more theoretical knowledge.
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Although self-evaluation is crucial in the practice of medicine, few educators have formally introduced self-assessment into the undergraduate medical curriculum. However, students in the baccalaureate-M.D. degree program at the University of Missouri, Kansas City, must complete a self-evaluation at the close of every medical school course and rotation during the last four years of a six-year curriculum. In this paper, the authors examine the self-ratings of 211 of these students as they progressed through the program in order to discover trends in and correlates of the self-assessments. Although the students' self-evaluations and faculty members' ratings of these students' performances rose year by year, the relationship between the students' and the faculty's ratings decreased through time. Yet, results suggest that self-evaluation has educational merit as a measure of noncognitive abilities associated with clinical performance and as a stimulus to further learning and professional development.
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The creation of sound self-judgement for students is an integral goal in any educational sphere. Student clinicians in dentistry must learn sufficient skills to be able to self-assess their performance very accurately, because after graduation, the nature of dental procedures means that others are seldom in a position to evaluate the quality of their work. Over recent years, the Department of Dentistry at the University of Adelaide has been developing a self-assessment procedure, initially as a pilot study in the subject oral diagnosis, and currently in all years of the course. This paper describes how self-assessment has been demonstrated to work initially in the pilot subject, and currently across the whole course. The paper also describes how the criteria for assessment and the levels of performance expected for each grade are established and how student performance is monitored. Finally, evidence is presented to indicate acceptance by the students of self-assessment as a valuable and integral part of their learning in dentistry.
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Self-awareness is an individual's tendency to pay attention to his or her own emotions, attitudes, and behavior in response to specific situations. In the case of physicians, self-awareness is their insight into how their emotional makeup influences patient care. Conceivably, such insight may improve doctors' professional performance. The authors review published approaches aimed at enhancing the self-awareness of medical students and draw attention to some problems in these approaches that call for further research. Published teaching programs of self-awareness may be classified as direct or indirect. The primary objective of direct programs is to promote students' insight into their own feelings and attitudes by classroom instruction or small-group discussions, during which students share with their peers their emotional responses to various clinical experiences. The primary objective of indirect approaches is to teach clinical skills, such as patient interviewing, patient counseling, and self-assessment. It has been claimed that these programs also enhance self-awareness by drawing students' attention to differences between students' assessment of their own performance and the assessments of their instructors and patients. Both types of programs should be given consideration for inclusion into the medical curriculum. However, since presently available evidence does not allow educators to identify an optimal teaching program, more study is needed concerning the effectiveness of the various approaches to teaching self-awareness. Specifically, an effort should be made to ascertain that the benefit of the direct approaches exceeds their cost in terms of time, teacher training, and-possibly-student embarrassment.
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A method of incorporating self and peer marking in an undergraduate electronics subject is described and discussed. Similar methods could probably be used in other technical subjects. Its educational benefits are: greatly improved feedback to the students, additional reinforcement, and practice at self assessment. The method described has a high degree of student acceptance, and appears to produce reliable and valid marks. It can be incorporated into conventionally taught courses without disrupting teaching. The use of self and peer assessment in an isolated subject requires a great deal of attention to the details of the procedure, especially if it is to be part of the formal assessment in the subject. The procedure developed here requires the preparation of detailed model solutions and an extensive clerical procedure, but alternatives with a simpler clerical process are also possible. The nature and amount of the examination load on faculty is different when self and peer marking is used. For small classes it involves more work for faculty, but for large classes it reduces the work load. It is one of the few educational innovations that can do this, and at the same time have educational benefits.
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Student learning for what? Usually we are thinking about student learning of facts related to scientific competence, but there is the equally important learning of attitudes and, through the complex process of identification, the development of a professional identity dedicated to applying acquired knowledge and skills to the care of the patient. At Western Reserve University, we are conducting a career study among our graduates because we are interested in looking, in the maximum depth possible in a survey, at many aspects of the physician's professional life and performance. And, indeed, we do intend to relate it to the learning experiences he had in medical school. One of the basic purposes of the study is to establish a baseline of what medical careers are like for the graduate educated under the more traditional program Western Reserve had formerly and to compare this baseline with the performance in careers of alumni
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• Interdepartmental teaching is one possible solution to the problems that arise from the increasing specialization within the faculties of medical schools. Unless these problems are solved, medical education will become progressively more fragmented and disjointed. The plan involves the creation of multidiscipline laboratories, in which a student has individual working space that is available to him 24 hours a day and seven days a week. The plan includes free time, supervised research projects, prolonged personal contacts between the student and individual patients, an intramural system of clinical preceptorship, and a redistribution of the traditional content of the medical curriculum into subject areas selected by the faculty. The initiation of this plan has required much time and effort, and its efficient administration is of the greatest importance. Once it is in operation, however, it requires no more instructor time than traditional department courses, and it helps the student to think like a physician from the start of his medical education.
The Physician and His Career
  • B H Mawardi