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SC3 Final-year medical students are unreliable self-assessors even when video-playback is utilised within the self-assessment cycle during emergency simulations
  1. Nick Peres1,2,
  2. Crowther I1,
  3. Gali H1,
  4. Rodham P1,
  5. Sayers J2,
  6. McMullan M3,
  7. Hallikeri P4,
  8. Anyiam O2,
  9. Oates E2,
  10. Caulfield L2,
  11. Forrest I2,
  12. Matthan J1
  1. 1Newcastle University, Faculty of Medicine, School of Medical Education, UK
  2. 2Newcastle upon Tyne NHS Foundation Trust, Newcastle, UK
  3. 3North Tees and Hartlepool NHS Foundation Trust, UK
  4. 4Queens Medical Centre, Nottingham University Hospitals Trust, UK

Abstract

Background Self-assessment is a skill required by clinicians for continuous professional development. Medical students struggle with the skill, largely due to the paucity of incorporating it into the undergraduate curriculum and the absence of a validated self-assessment cycle. Several studies suggest video-playback used in a simulated environment may be an effective learning and teaching tool. We aimed to investigate whether students’ evaluation of their performance in a simulated environment before and after video-playback correlated with those of qualified clinicians’ evaluation, and whether their self-assessment skills improved with the use of video-playback, in order to gauge the usefulness of video-playback within the self-assessment process for simulated scenarios.

Methodology Consented recordings of final-year medical students (n = 90) leading an emergency simulation scenario were made over two five-month periods in 2015 and 2016. Students and assessors used identical marking schemes. Students self-assessed their performance before and after video-playback and their scores were compared against markers’ scores. Statistical analysis of data was conducted.

Results 91% of students scored their performance lower than clinician assessors prior to video-playback. After video-playback, 60% demonstrated an increase in self-assessment scores, whilst 40% showed a decrease. Students continued to score themselves significantly lower than their assessors following video-playback (P < 0.001). No demonstrable correlation was noted between student and clinician scores.

Conclusions and recommendations Our results suggest that students may be able to self-assess more accurately following video-playback, although self-assessment remains challenging for a significant proportion. While the ability to self-assess improves for the majority of final-year medical students following video-playback and reassessment of their performance, they remain harsh self-assessors. Utilising video-playback for self-assessment purposes within the feedback process can only be cautiously adopted with phased, incremental and guided use of self-assessment. The development of a validated self-assessment framework is recommended before widespread use within the undergraduate curriculum.

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