Abstract
Objective
To examine the increase in self-perceived clinical competence during a three-year postgraduate training in general practice and to explore the relation between the growth of self-perceived competence and several background variables.
Design
Cohort, 1995–1998.
Setting
Three-year Postgraduate Training for General practice in the Netherlands
Participants
All Dutch trainees who followed postgraduate training from September 1995 to September 1998 (N=191).
Intervention
We asked the trainees at the start and at the end of their postgraduate training to complete a questionnaire, which assessed their self-perceived knowledge, clinical skills and consultations skills.
We collected information about potentially influencing background variables. Amongst these were variables such as: age, gender, prior medical experience, the effort someone has spent upon her/his education, insight in weak and strong areas of clinical competence and knowledge and skills levels.
Main outcome measure
Self-perceived competence.
Results
A total of 127 trainees completed both questionnaires (190 at the first administration and 128 at the second one).
We found statistically significant growth of self-perceived clinical competence. Self-perceived consultation skills increased more than self-perceived knowledge and clinical skills. The afore mentioned background variables did not relate in any way with the growth of self-perceived clinical competence.
Conclusion
This study shows that a 3-year postgraduate training in general practice enhances self-perceived clinical competence. However, we still do not know how to explain this improvement. Further study into the theoretical concept of self-assessment in medical education and into the factors contributing to the feeling of being competent, is required.
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References
Anonymous, (1997). SPSS Advanced Statistics 7.5 SPSS Inc. Chicago pp.89–130
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
Bleys F.C., Gerritsma J.G.M., Netjes I., (1986). Skills development by medical students and the influence of prior experience: a study using evaluations by students and self-assessment Medical Education 20:234–239
Boud D., (1989). The role of self-assessment in student grading Assessment and evaluation in higher education 14:20–30
Calhoun J.G., Ten Haken J.D., Woolliscroft J.O., (1990). Medical students’ development of self- and peer-assessment skills: a longitudinal study Teaching and Learning in Medicine 2:25–29
Coutts L., Rogers J., (1999). Student assessment and standardized patients – will the questions never end? Academic Medicine 74(10 Suppl): S128–S130
Cronbach L.J., (1970). How we should measure ‘change’– or should we? Psychology Bulletin 74:68–80
DiMatteo M.R., DiNicola D.D., (1981). Sources of assessment of physician performance: a study of comparative reliability and patterns of intercorrelation Medical Care 19:829–839
Donald J.B., Thomson D., (1993). Evaluation of a computerized assessment package for general practitioner trainees British Journal of General Practice 43:115–118
Dubois V., Everwijn S., Van Geldorp G., et al., (1987). The Construction of a New Curriculum of Postgraduate Training for General Practice in The Netherlands Royal Dutch Medical Association (KNMG) Utrecht
Eva K.W., Regehr G., (2005). Self-assessment in the health professions: a reformulation and research agenda Academic Medicine 80(10 Suppl): S46–S54
Fitzgerald J.T., Gruppen L.D., White C.B. (2000). The influence of task formats on the accuracy of medical students’ self-assessments Academic Medicine 75: 737–741
Fox R.A., Ingham Clark C.L., Scotland A.D., Dacre J.E., (2000). A study of pre-registration house officers’ clinical skills Medical Education 34:1007–1012
Friedlich M., MacRae H., Oandasan I., Tannenbaum D., Batty H., Reznick R., Regehr G., (2001) Structured assessment of minor surgical skills (SAMSS) for family medicine residents. Academic Medicine 76:1241–1246
Gordon M.J., (1991). A review of the validity and accuracy of self-assessments in health professions training Academic Medicine 66:762–769
Harrington J.P., Murnaghan J.J., Regehr G., (1997). Applying a relative ranking model to the self-assessment of extended performances Advances in Health Sciences Education 2:17–25
Harris M.H., Schaubroeck J., (1988). A meta-analysis of self-supervisor, self-peer, and peer-supervisor ratings Personnel Psychology 41:43–62
Irvine D., (1997). The performance of doctors. I: Professionalism and self regulation in a changing world British Medical Journal 314: 1540–1542
Jansen J.J.M., Grol R.P.T.M., Crebolder H.F.J.M., Rethans J.J., Van der Vleuten C.P.M., (1998). Failure of feedback to enhance self-assessment skills of general practitioners Teaching and Learning in Medicine 10:145–151
Johnson D., Cujec B., (1998). Comparison of self, nurse, and physician assessment of residents rotating through an intensive care unit Critical Care Medicine 26:1811–1816
Kegel-Flom P., (1975). Predicting supervisor, peer, and self ratings of intern performance Journal of Medical Education 50:812–815
Kramer A.W.M., Zuithoff P., Düsman H., Jansen J.J.M., Tan L.H.C., Grol R.P.T.M., Van der Vleuten C.P.M., (2002). Predictive validity of a written knowledge test of skills in postgraduate training for general practice Medical Education 36:812–819
Kramer A.W.M., Düsman H., Tan L.H.C., Jansen J.J.M., Grol R.P.T.M., Van der Vleuten C.P.M., (2003a). Effect of extension of postgraduate training in general practice on the acquisition of knowledge of trainees Family Practice 20:207–212
Kramer A.W.M., Jansen J.J.M., Düsman H., Tan L.H.C., Van der Vleuten C.P.M., Grol R.P.T.M., (2003b). Acquisition of clinical skills in postgraduate training for general practice British Journal of General Practice 53:677–682
Kramer A.W.M., Düsman H., Tan L.H.C., Jansen J.J.M., Grol R.P.T.M., Van der Vleuten C.P.M., (2004). Acquisition of communication skills in postgraduate training for general practice Medical Education 38:158–167
Lamberts, H. & Wood, M. (eds.) (1987). ICPC. International Classification of Primary Care. Oxford: Oxford University Press
Marel G.M., Lyon P.M., Field M.J., Barnsley L., Hibbert E., Parise A., (2000). Clinical skills in early postgraduate medical training: patterns of acquisition of confidence and experience among junior doctors in a university teaching hospital Medical Education 34:1013–1015
Martin D., Regehr G., Hodges B., McNaughton N., (1998). Using videotaped benchmarks to improve the self-assessment ability of family practice residents Academic Medicine 73:1201–1206
Mattheos N., Nattestad A., Falk-Nilsson E., Attström R., (2004). The interactive examination: assessing students’ self-assessment ability Medical Education 38:378–389
Miller G.E., (1976) Continuous assessment Medical Education 10:81–86
Oermann, M.H. (1998). Professional reflection: have you looked in the mirror lately? Orthopaedic Nursing 22–26
Purdy M., (1997). The problem of self-assessment in nurse education Nurse Education Today 17:135–139
Rezler A.G., (1989). Self-assessment in problem-based groups Medical Teacher 11:151–156
Risucci D.A., Tortolani A.J., Ward R.J., (1989). Ratings of surgical residents by self, supervisor and peers Surgery, Gynecology & Obstetrics 169:519–526
Speechly M., Weston W.W., Dickie G.L., Orr V., (1994). Self-assessed competence: before and after residency Canadian Family Physicians 40:459–464
Stuart M.R., Goldstein H.S., Snope F.C., (1980). Self-evaluation by residents in family medicine Journal of Family Practice 10:639–642
Swanwick T., (2005). Informal learning in postgraduate medical education: from cognitivism to ‘culturism’ Medical Education 39:859–865
Tracey J.M, Arroll B., Richmond D.E., Barham P.M., (1997) The validity of general practitioners’ self assessment of knowledge: cross sectional study British Medical Journal 315:1426–1428
Ward M., Gruppen L., Regehr G., (2002). Measuring self-assessment: current state of the art Advances in Health Sciences Education 7:63–80
Woolliscroft J.O., Ten Haken J., Smith J., Calhoun J.G., (1993) Medical students’ clinical self-assessments: comparisons with external measures of performance and the students’ self-assessments of overall performance and effort Academic Medicine 68:285–294
Acknowledgements
We like to thank all trainees who took part in the study. We are grateful for the support from the staff of the eight Dutch training institutes for postgraduate training in general practice. We thank the members of the national committees of the knowledge tests for their contribution in the development of the tests. Herman Düsman contributed in the design of the study, the administration and the analysis. IJsbrand Kramer improved the English. This study was initiated by the Registration Committee for Postgraduate Training in General Practice (HVRC). It was financially supported by the Foundation of Postgraduate Training in General Practice (SBOH), that had no involvement in the study at all. And it was executed by the National Centre for Evaluation of Postgraduate Training in General Practice (SVUH).
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Kramer, A., Zuithoff, P., Jansen, J. et al. Growth of Self-Perceived Clinical Competence in Postgraduate Training for General Practice and its Relation to Potentially Influencing Factors. Adv Health Sci Educ Theory Pract 12, 135–145 (2007). https://doi.org/10.1007/s10459-006-9001-y
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DOI: https://doi.org/10.1007/s10459-006-9001-y
Keywords
- contribution of an educational program to the feeling of being competent
- factors contributing to the feeling of being competent
- growth of self-perceived clinical competence
- lifelong learning
- postgraduate training in general practice
- self-assessment of clinical competence
- self-perceived clinical competence
- theoretical concept of self-assessment