SC3 Final-year medical students are unreliable self-assessors even when video-playback is utilised within the self-assessment cycle during emergency simulations

• Published in: BMJ simulation & technology enhanced learning Vol. 2; no. Suppl 1; p. A5
• Main Authors: Peres, Nick, I, Crowther, H, Gali, P, Rodham, J, Sayers, M, McMullan, P, Hallikeri, O, Anyiam, E, Oates, L, Caulfield, I, Forrest, J, Matthan
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group LTD 01.11.2016
• Subjects: Curricula; Medical students; Self evaluation; Students
• ISSN: 2056-6697
• DOI: 10.1136/bmjstel-2016-000158.13

BackgroundSelf-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.MethodologyConsented 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.Results91% 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 recommendationsOur 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.