The 'unskilled and unaware' : self-assessment in a real world setting

Abstract

Self-assessment ability in medical students and practising physicians is generally poor yet essential for academic progress and professional development. The aim of this study was to determine undergraduate medical students ability to accurately self assess their exam performance in a real-world, high-stakes exam setting, something not previously investigated. Year 1 and Year 2 medical students (n = 199) participated in a self-assessment exercise. Students predicted their exam score (%) on the anatomy practical exam. This exercise was completed online, immediately after the exam. Students’ predicted exam scores were correlated with their actual attained exam scores using a Pearson’s correlation. Demographic data was analysed using an independent t-test. A negative correlation was found between students’ predicted and attained exam scores. There was no relationship between the students’ entry status into medical school and self-assessment ability or between males and females. However, a relationship was determined for these variables in year 2. The number of hours of additional self-directed learning undertaken did not influence students’ self-assessment. Our results demonstrate the ‘unskilled and unaware’ phenomenon in a real-world, higherstakes and practice-related setting. Students were unable to self-assess their exam performance. Poor performers were shown to overestimate their ability, and conversely, high achievers underestimated their performance. We present evidence of a strong, significant linear relationship between medical students’ ability to self-assess their performance in an anatomy practical exam, and their actual performance; in a real world setting. These findings will enable faculty to guide students on their journey to becoming reflective practitioners and reflective anatomy students.