Evaluation of Perceived and Actual Competency in a Family Medicine Objective Structured Clinical Examination

Overview

Journal Can Fam Physician

Specialties General Medicine
Public Health

Date 2017 Apr 14

PMID 28404722

Citations 7

Authors

Lisa Graves

Leonora Lalla

Meredith Young

Affiliations

Soon will be listed here.

Abstract

Objective: To examine the relationship between objective assessment of performance and self-rated competence immediately before and after participation in a required summative family medicine clerkship objective structured clinical examination (OSCE).

Design: Learners rated their competence (on a 7-point Likert scale) before and after an OSCE along 3 dimensions: general, specific, and professional competencies relevant to family medicine.

Setting: McGill University in Montreal, Que.

Participants: All 168 third-year clinical clerks completing their mandatory family medicine rotation in 2010 to 2011 were invited to participate.

Main Outcome Measures: Self-ratings of competence and objective performance scores were compared, and were examined to determine if OSCEs could be a "corrective" tool for self-rating perceived competence (ie, if the experience of undergoing an assessment might assist learners in recalibrating their understanding of their own performance).

Results: A total of 140 (83%) of the third-year clinical clerks participated. Participating in an OSCE decreased learners' ratings of perceived competence (pre-OSCE score = 4.9, post-OSCE score = 4.7; = 4.2; < .05). Learners' mean self-rated competence for all categories of behaviour (before and after) showed no relationship to OSCE performance ( < 0.12 and > .08 for all), nor did ratings of station-relevant competence (before and after) ( < 0.19 and > .09 for all). Ratings of competence before and after the OSCE were correlated for individual students ( > 0.40 and < .001 for all).

Conclusion: After the OSCE, students' self-ratings of perceived competence had decreased, and these ratings had little relationship to actual performance, regardless of the specificity of the rated competency. Discordance between perceived and actual competence is neither novel nor unique to family medicine. However, this discordance is an important consideration for the development of competency-based curricula.

Citing Articles

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References

Mann K, van der Vleuten C, Eva K, Armson H, Chesluk B, Dornan T . Tensions in informed self-assessment: how the desire for feedback and reticence to collect and use it can conflict. Acad Med. 2011; 86(9):1120-7. DOI: 10.1097/ACM.0b013e318226abdd. View

Cruess R, Cruess S, Johnston S . Renewing professionalism: an opportunity for medicine. Acad Med. 1999; 74(8):878-84. DOI: 10.1097/00001888-199908000-00010. View

Eva K, Regehr G . Self-assessment in the health professions: a reformulation and research agenda. Acad Med. 2005; 80(10 Suppl):S46-54. DOI: 10.1097/00001888-200510001-00015. View

Harden R, Stevenson M, Downie W, WILSON G . Assessment of clinical competence using objective structured examination. Br Med J. 1975; 1(5955):447-51. PMC: 1672423. DOI: 10.1136/bmj.1.5955.447. View

Eva K, Regehr G . "I'll never play professional football" and other fallacies of self-assessment. J Contin Educ Health Prof. 2008; 28(1):14-9. DOI: 10.1002/chp.150. View

Harris P, Snell L, Talbot M, Harden R . Competency-based medical education: implications for undergraduate programs. Med Teach. 2010; 32(8):646-50. DOI: 10.3109/0142159X.2010.500703. View

Patricio M, Juliao M, Fareleira F, Vaz Carneiro A . Is the OSCE a feasible tool to assess competencies in undergraduate medical education?. Med Teach. 2013; 35(6):503-14. DOI: 10.3109/0142159X.2013.774330. View

Davis D, Mazmanian P, Fordis M, Harrison R, Thorpe K, Perrier L . Accuracy of physician self-assessment compared with observed measures of competence: a systematic review. JAMA. 2006; 296(9):1094-102. DOI: 10.1001/jama.296.9.1094. View

Regehr G, Freeman R, Robb A, Missiha N, Heisey R . OSCE performance evaluations made by standardized patients: comparing checklist and global rating scores. Acad Med. 1999; 74(10 Suppl):S135-7. DOI: 10.1097/00001888-199910000-00064. View

10.

Sterkenburg A, Barach P, Kalkman C, Gielen M, Ten Cate O . When do supervising physicians decide to entrust residents with unsupervised tasks?. Acad Med. 2010; 85(9):1408-17. DOI: 10.1097/ACM.0b013e3181eab0ec. View

11.

Patricio M, Juliao M, Fareleira F, Young M, Norman G, Vaz Carneiro A . A comprehensive checklist for reporting the use of OSCEs. Med Teach. 2009; 31(2):112-24. DOI: 10.1080/01421590802578277. View

12.

Irby D, Cooke M, OBrien B . Calls for reform of medical education by the Carnegie Foundation for the Advancement of Teaching: 1910 and 2010. Acad Med. 2010; 85(2):220-7. DOI: 10.1097/ACM.0b013e3181c88449. View

13.

Barnsley L, Lyon P, Ralston S, Hibbert E, Cunningham I, Gordon F . Clinical skills in junior medical officers: a comparison of self-reported confidence and observed competence. Med Educ. 2004; 38(4):358-67. DOI: 10.1046/j.1365-2923.2004.01773.x. View

14.

Turner N, Lukkassen I, Bakker N, Draaisma J, Cate O . The effect of the APLS-course on self-efficacy and its relationship to behavioural decisions in paediatric resuscitation. Resuscitation. 2009; 80(8):913-8. DOI: 10.1016/j.resuscitation.2009.03.028. View

15.

Pell G, Homer M, Fuller R . Investigating disparity between global grades and checklist scores in OSCEs. Med Teach. 2015; 37(12):1106-13. DOI: 10.3109/0142159X.2015.1009425. View

16.

Sargeant J, Eva K, Armson H, Chesluk B, Dornan T, Holmboe E . Features of assessment learners use to make informed self-assessments of clinical performance. Med Educ. 2011; 45(6):636-47. DOI: 10.1111/j.1365-2923.2010.03888.x. View

17.

Ammentorp J, Thomsen J, Jarbol D, Holst R, Ovrehus A, Kofoed P . Comparison of the medical students' perceived self-efficacy and the evaluation of the observers and patients. BMC Med Educ. 2013; 13:49. PMC: 3706304. DOI: 10.1186/1472-6920-13-49. View

18.

Hodges B, Regehr G, Martin D . Difficulties in recognizing one's own incompetence: novice physicians who are unskilled and unaware of it. Acad Med. 2001; 76(10 Suppl):S87-9. DOI: 10.1097/00001888-200110001-00029. View

19.

Cruess R, Cruess S . Teaching professionalism: general principles. Med Teach. 2006; 28(3):205-8. DOI: 10.1080/01421590600643653. View

20.

Frank J, Snell L, Ten Cate O, Holmboe E, Carraccio C, Swing S . Competency-based medical education: theory to practice. Med Teach. 2010; 32(8):638-45. DOI: 10.3109/0142159X.2010.501190. View