Abstract
As the rapidity with which medical knowledge isgenerated and disseminated becomes amplified,an increasing emphasis has been placed on theneed for physicians to develop the skillsnecessary for life-long learning. One suchskill is the ability to evaluate one's owndeficiencies. A ubiquitous finding in thestudy of self-assessment, however, is thatself-ratings are poorly correlated with otherperformance measures. Still, many educatorsview the ability to recognize and communicateone's deficiencies as an important component ofadult learning. As a result, two studies havebeen performed in an attempt to improve uponthis status quo.First, we tried to re-define the limits withinwhich self-assessments should be used, usingRosenblit and Keil's argument that calibrationbetween perceived and actual performance willbe better within taxonomies that are regularlytested (e.g., factual knowledge) compared tothose that are not (e.g., conceptualknowledge). Second, we tried to norm referenceindividuals based on both the performance oftheir colleagues and their own historicalperformance on McMaster's Personal ProgressInventory (a multiple choice question test ofmedical knowledge).While it appears that students are able to (a)make macro-level self-assessments (i.e., torecognize that third year students typicallyoutperform first year students), and (b) judgetheir performance relatively accurately afterthe fact, students were unable to predict thepercentage of questions they would answercorrectly with a testing procedure in whichthey have had a substantial amount of feedback. Previous test score was a much better predictorof current test performance than wereindividuals' expectations.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Arnold, L., Willoughby, T.L. & Calkins, E.V. (1985). Self-evaluation in undergraduate medical education: A longitudinal perspective. Journal of Medical Education 60: 21–28.
Blake, J.M., Norman, G.R. & Smith, E.K.M. (1995). Report card from McMaster: student evaluation at a problem-based medical school. Lancet 345: 899–902.
Blake, J.M., Norman, G.R., Keane, D.R., Mueller, C.B., Cunnington, J. & Didyk, N. (1996). Introducing progress testing inMcMaster University's problem-based medical curriculum: psychometric properties and effect on learning. Academic Medicine 71: 1002–1007.
e.pdf} (last accessed Dec. 12, 2002).
Cunnington, J.P.W., Norman, G.R., Blake, J.M., Dauphinee, W.D. & Blackmore, D.E. (1996).Applying Learning Taxonomies to Test Items: is a fact an artifact? Academic Medicine 71(suppl): S31–S33.
Day, S.C., Norcini, J.J., Webster, G.D., Viner, E.D. & Chirico, A.M. (1988). The effect of changes in medical knowledge on examination performance at the time of recertification. Proceedings of the Annual Conference of Research in Medical Education 27: 139–144.
Fitzgerald, J.T., White, C.B. & Gruppen, L.D. (2002). A longitudinal study of self-assessment accuracy. Abstract presented at the annual meeting of the Association of American Medical Colleges.
Gordon, M.J. (1991). A review of the validity and accuracy of self-assessments in health professions training. Academic Medicine 66: 762–769.
Gordon, M.J. (1992). Self-assessment programs and their implications for health professions training. Academic Medicine 67: 672–679.
Keil, F. (2001). The ends, and beginnings, or science in the head: coming to grasp the causal structure of the world. Presented at Department of Psychology Colloquium, McMaster University.
Kruger, J. & Dunning, D. (1999). Unskilled and unaware of it: how difficulties in recognizing one's own incompetence lead to inflated self-assessments. Journal of Personality and Social Psychology 77: 1121–1134.
Muller, S. (Chair) (1984). Physicians for the twenty-first century: report of the project panel on the general professional education of the physician and college preparation for medicine. JMed Educ 59, Part 2.
Rezler, A. (1989). Self-assessment in problem-based groups. Medical Teacher 11: 151–156.
Rozenblit, L.R. & Keil, F.C. (2002). The misunderstood limits of folk science: an illusion of explanatory depth. Cognitive Science 26: 521–562.
Sackett, D.L. & Rosenberg, W.M. (1995). The need for evidence-based medicine. Journal of the Royal Society of Medicine 88: 620–624.
Shin, J.H., Haynes, R.B. & Johnston, M.E. (1993). Effect of problem-based, self-directed undergraduate education on life-long learning. CMAJ 148: 969–976.
Sibley, J.C., Sackett, D.L., Neufeld, V., Gerrard, B., Rudnick, K.V. & Fraser, W. (1982). A randomized trial of continuing medical education. New England Journal of Medicine 306: 511–515.
Walton, H.J. & Matthews, M.B. (1989). Essentials of problem-based learning. Med Educ 23: 542–558.
Ward, M., Gruppen, L. & Regehr, G. (2002). Measuring self-assessment: current state of the art.Advances in Health Sciences Education 7: 63–80.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Eva, K.W., Cunnington, J.P., Reiter, H.I. et al. How Can I Know What I Don't Know? Poor Self Assessment in a Well-Defined Domain. Adv Health Sci Educ Theory Pract 9, 211–224 (2004). https://doi.org/10.1023/B:AHSE.0000038209.65714.d4
Issue Date:
DOI: https://doi.org/10.1023/B:AHSE.0000038209.65714.d4