Doctors Get Poor Grades in Self-Assessment

External observations better measures of physicians' competence

TUESDAY, Sept. 5 (HealthDay News) -- Physicians are limited in their ability to accurately self-assess their own learning needs and to choose educational activities to meet those needs, according to a study in the Sept. 6 issue of the Journal of the American Medical Association.

David A. Davis, M.D., of the University of Toronto in Ontario, Canada, and colleagues examined 17 studies that compared physicians' self-reports on their need for continuing medical education with external observations.

Of 20 comparisons made between self-assessment and external observations, 13 had little, no, or an inverse relationship, while seven had positive associations. Several studies found that the worst self-assessment accuracy came from the least-skilled physicians and from those who expressed the most confidence. These findings, the authors note, are consistent with those seen in other professions.

Even though evidence is "suboptimal in quality," the preponderance of evidence suggests physicians do poorly in self-assessment and that "new initiatives and formats are needed to assist the self-assessment process and to more accurately promote and assess broader domains of competence such as professionalism and lifelong learning," the authors state. "Ultimately, a more useful approach may be to focus on externally determined self-assessments to guide the clinician in the use of educational and other activities designed to improve performance."

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