Failure of Feedback to Enhance Self-Assessment Skills of General Practitioners

Abstract

Background: Self-directed learning requires accurate self-assessment, but research evidence shows poor validity of self-assessment. Training in self-assessment may improve validity. Purpose: To investigate if repeated personal feedback based on objective knowledge and skill scores enhances self-assessment skills of practicing general practitioners. Method: Participants were general practitioners (n = 60), who received skills training covering 4 clinical skills at3 months (Group A)or 6 months (Group B)after enrollment in the study. Participants were tested at 3-month intervals with a knowledge test (60 items), a performance-based test (4 stations), and a self-assessment questionnaire (22 items), covering the four different clinical skills. They received personal feedback on the results. Results: At 3 months, mean scores on the self-assessment questionnaire and knowledge test had increased significantly more in Group A compared to Group B, but at 6 months no differences in mean scores remained. Correlations between self-assessment rating and objective scores were low to moderate, with little overall improvement over time. Conclusions: Although self-assessment scores can to some extent be useful in measuring perceived changes in competence in groups, individual self-assessment scores on their own are an invalid source of information concerning competence of practicing physicians, and this does not improve significantly with regular feedback.