Self-assessment Of Performance Research Articles

An importance–performance analysis (IPA) of teachers’ core competencies for implementing maker education in primary and secondary schools

To encourage the creative design, hands-on, and problem-solving abilities of K–12 students, many countries have begun to set up makerspaces and promote maker education in schools. To help primary and secondary schools better implement maker education, this study explored the core competencies of teachers striving to engage or better practice maker education, investigating their perspectives on these core competencies and determining their competency levels. The study employed a two-step investigative approach: one, a focus group discussed and identified teachers’ required knowledge and competencies; and two, an importance–performance self-assessment survey was conducted among teachers who participated in the Maker Education and Technology Center Program in primary and secondary schools in Taiwan. Descriptive statistics and analysis of variance were used in this study. According to the findings, the teachers generally recognized as important the core competencies the researchers discussed. However, the level of importance they assigned each item was high compared with their self-assessments of the core competencies, which suggests the need for better implementation of maker education. Successful maker education requires teachers to work in their professional fields, gain technology knowledge and skills, and build interdisciplinary connections to facilitate project-based learning. The results identified some principles to improve the professional development of maker educators.

Adverse events in facial plastic surgery: Data-driven insights into systems, standards, and self-assessment.

Complications in facial plastic surgery can lead to pain, suffering, and permanent harm. Yet, the etiology and outcomes of adverse events are understudied. This study aims to determine the etiology and outcomes of adverse events reported in aesthetic facial plastic surgery and identify quality improvement opportunities. A cross-sectional survey analysis was conducted using an anonymous 22-item questionnaire distributed to members of the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) and American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS). Participants were queried on demographics, practice type, and adverse events related to aesthetic facial surgeries. Two hundred fifty-three individuals participated; nearly half of respondents (49.0%) held membership in both AAO-HNS and AAFPRS. Of these, 40.8% of respondents reported at least one adverse event within the past 12months of practice. A total of 194 adverse events were reported, most commonly related to facelift (n=59/194, 30.4%), rhinoplasty (n=55/194, 28.4%), and injection procedures (n=38/194, 19.6%), with hematoma or seroma being the most commonly described. Most adverse events were self-limited, but approximately 68% resulted in further procedures. Surgeon error or poor judgement (n=42) and patient non-adherence (n=18) were the most commonly ascribed reasons for adverse events; 37.1% of participants reported a change in clinical practice after the incident. Adverse events were not infrequent in facial plastic surgery. Understanding these adverse events can provide impetus for tracking outcomes, standardization, and engagement with lifelong learning, self-assessment, and evaluation of practice performance.

Midwifery students better approximate their self-efficacy in clinical lactation after reflecting in and on their performance in the LactSim OSCE

BackgroundMidwives are expected to support women with lactation initiation and maintenance. Midwifery students engaged in a simulation-based exercise (LactSim OSCE) where they role-played the clinician and the breastfeeding patient by wearing a high-fidelity breast model. We provided participants opportunities for reflecting in and on practice to compare their perceived self-confidence in clinical lactation skills to actual clinical performance. We also describe feasibility of implementing the LactSim OSCE with an emphasis on preparation and time spent on tasks during the OSCE.MethodsAudio-video recordings from the LactSim OSCE were viewed and assessed using a technical skills checklist by an independent rater and by the study participants as part of the self-reflection. Mixed data on participants’ self-efficacy in clinical lactation, experience with the LactSim OSCE, and self-assessment of clinical performance were collected in survey instruments and a focus group. Time spent on each component and clinical lactation skill during the LactSim OSCE was documented.ResultsImmediately following the LactSim OSCE, participants’ confidence in clinical lactation was high (5.7/7), but after a guided video reflection exercise, their self-efficacy was 4.4/7. Participants spent approximately 2 of the allotted 10 min per case scenario discussing the OSCE logistics due to inadequate preparation. Participants spent approximately 2 min of the total encounter performing hands-on clinical lactation skills by touching, looking at, or using the high-fidelity breast model worn by their peer.ConclusionWe described the development and evaluation of the first simulated experience in clinical lactation with all three components of fidelity: conceptual, psychological, and physical. Multiple opportunities for reflecting on performance allowed the nurse-midwifery students to evaluate their competence in decision-making, technical, and counseling skills which resulted in a more realistic approximation of their perceived self-confidence in breastfeeding skills. Another innovation of this pilot work is the documentation of how long a learner spends on various tasks relevant to lactation support in a simulated encounter. Our findings highlight the importance of providing multiple opportunities for self-reflection using guided video reflection and checklists for objective self-assessment in the clinical lactation field.

Síndrome de Burnout y desempeño laboral en el personal de salud

Los profesionales de salud son los más vulnerables a factores que desencadenan estrés laboral asociado al síndrome de Burnout, que suele afectar a su desempeño laboral y a la calidad de su atención, ocasionando frecuentes reclamos por parte de los usuarios, en particular en el primer nivel de atención del sistema de salud. Objetivo: Identificar la presencia del síndrome de Burnout en sus 3 dimensiones: agotamiento emocional, despersonalización, realización personal, identificar el nivel de desempeño laboral en sus cuatro escalas: calidad técnica y atención médica, capacitación y educación continua, productividad, aptitudes; y establecer si hay relación entre el síndrome de Burnout y el desempeño laboral en el personal de salud del Centro de Salud Vallecito I-3, Puno (Perú). Método: Descriptivo-correlacional, la muestra estuvo constituida por el total de trabajadores del establecimiento de salud. Los instrumentos fueron el test Maslach Burnout Inventory y el cuestionario de autoevaluación del desempeño laboral. Resultados: Síndrome de Burnout 7.09 en una escala de 1 a 10 (s=2.32), desempeño laboral 35.71 en una escala de 0 a 40 (s = 0.81), no existe correlación entre ambas variables (r=0.063). Conclusión: Se concluye que el síndrome de Burnout es de nivel medio, el desempeño laboral es alto y que no se establece relación entre el síndrome de Burnout y el desempeño laboral del personal de salud.

Performance Assessment of R&D-Intensive Manufacturing Companies on Dynamic Capabilities

In today's business landscape, improving competitive advantage of manufacturing companies depends on their continuous performance improvement. This necessitates a generic and multi-dimensional view that organisational and managerial processes should be assessed by the underlying micro-foundation of dynamic capabilities (DC) in conjunction with enhanced new product development (NPD) projects. This study aims to propose an operationalised model of the conceptual DC framework including sensing, seizing, and reconfiguration capacities. The advantage of the two aforementioned models, which are based on a multi-criteria decision analysis (MCDA) framework, is that they can assist managers in the automotive industry to identify improvement plans and goals for sound and robust decision making. For this purpose, the evidential reasoning (ER) approach, which is realised in the intelligent decision system (IDS) software tool, is employed to perform performance self-assessment for the selected manufacturing companies on DC. This study provides managers with a useful tool to assess their company's strengths and weaknesses in regard to the DC components.

Physiotherapy students' self-assessment of performance-Are there gender differences in self-assessment accuracy?

The ability to critically appraise one's performance is paramount in physiotherapy and, although there is a paucity of research in this area, factors such as gender have been suggested to moderate the self-assessment accuracy of healthcare students. The purpose of this study was to determine a posteriori self-assessment accuracy of first-year physiotherapy students following a multiple-choice anatomy examination and to determine the specific influence of gender as a potential moderator of self-assessment accuracy. One-hundred-and-forty-two students (n = 72 female) enrolled in their second semester of a three-and-a-half-year physiotherapy programme participated in the study. A purpose-made self-assessment questionnaire was used to measure the students' self-assessment ability, estimating their performance on 11 different anatomical categories following the examination. This was then compared with a criterion measure matched with the questionnaire. The accuracy of the students' self-assessment was investigated by the relation between self-assessment and objective performance. The study showed low-to-moderate self-assessment accuracy (rho ranging from 0.318 to 0.675) with the students underestimating their performance in six out of 11 categories (p < 0.019). Gender did not contribute significantly to differences in accuracy between students' self-assessment and the criterion measure (p = 0.474). According to the results, the students demonstrated low-to-moderate self-assessment accuracy when compared to their performance. Notably, the results clearly showed that gender did not function as a moderator of self-assessment accuracy among first-year physiotherapy students.

Search Dog Handlers Show Positive Bias When Scoring Their Own Dog's Performance.

Self-assessments of performance are commonly used in the human workplace, although compared to peer or supervisor ratings, they may be subject to positive biases or leniency. The use of subjective ratings scales in animal sciences is also common, although little consideration is usually given to possible rater bias. Dog handlers, work very closely and form strong relationships with their dogs and are also best placed to monitor dog performance since they often work in isolation. Previous work found ratings of search dog performance correlated well between experienced dog trainers, instructors, and scientists; but until now, there has been no investigation into ratings made by a dog's own handler. We compared handlers' subjective assessment of their own dog's search performance to scores given by other handlers and in a second study, to scores made by impartial raters. We found that handlers generally showed leniency; for example scoring their own dogs more favorably for Control (responsiveness to commands) and Strength of Indication. But the degree of bias varied with the trait being scored and between raters. Such differences may be attributable to greater desirability or importance of favorable scores for certain traits, or a lack of clarity of their precise meaning. Handlers may vary in susceptibility to bias due to differing levels of experience and the extent to which they view their dog's ability as dependent on their own. The exact causes require further investigation. We suggest working dog agencies provide rater-training to overcome leniency, improve reliability and validity, and to increase handler's motivation to provide accurate assessments. This study represents one of a series of steps to formulate robust, validated and evidence-based performance rating systems and has relevance to any situation where raters assess their own performance or others (particularly where they may have a vested interest in, or loyalty toward, the ratee).

Predictors associated with studies and lifestyle and subjective feeling of depressive symptoms among Polish medical students

Introduction and objective. Depression is a disorder that medical students are subjected to. The aim of the research was to investigate the occurrence of subjective feeling of depressive symptoms among Polish medical students during the course of medical studies and to determine predictors of this phenomenon that are associated with studies and lifestyle. Material and method. The research tool was author’s questionnaire. 1023 medical students from each year of medical education and different Polish universities took part in the study. Results. 52.79% of the respondents had noticed symptoms that might had pointed to depression during the course of their medical studies. The research suggests that predictors of subjective feeling of depressive symptoms among medical students are: repeating a university subject, repeating a year in university, low self-assessment of academic performance during studying, considering dropping out of university, low satisfaction from the choice of studying medicine, reaching for alcohol in order to de-stress or discharge negative emotions, not having interests that enable to relax, not doing sports regularly, not participating in social gatherings often enough, not sleeping enough, having problems with maintaining stable body weight and not being religious. Conclusions. There are many lifestyle and studies connected factors associated with depressive symptoms among Polish medical students. The study suggests that it is important for students and their communities to pay attention to the emergence of them in order to improve the well-being of students.

Perceived dental care need and actual oral health status in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL).

To evaluate the performance of subjective self-assessment of dental care need with objective oral disease status in a sample of Hispanics/Latinos. Data from 13,561 participants of the 2008-2011 Hispanic Community Health Study/Study of Latinos were analyzed using complex survey procedure in SAS 9.4. Subjective self-reports of types of dental care needed (check-up or cleaning, teeth filled, teeth pulled, gum treatment, denture repair) were validated against objectively determined oral disease status [dental decay, periodontitis, bleeding on probing (BOP) and count of missing teeth]. Individuals who reported needing a cleaning/checkup were twice as likely to present with BOP upon oral examination (POR = 2.01, 95% CI: 1.54, 2.63). Similarly, individuals who reported needing gum treatment were more likely to present with periodontitis (POR = 1.96, 95% CI: 1.71, 2.24) and BOP (POR = 2.70, 95% CI: 2.37, 3.07) upon oral examination. In multivariable prediction modeling, demographic factors and subjective dental care measures were associated with the respective oral disease states. Moreover, the sensitivity, specificity, and area under the ROC curve for the count of missing teeth were, respectively, 77 percent, 57 percent, and 0.84, while the positive predictive value (PPV) was 26 percent. In bivariate analysis, self-reported type of dental care needed appear indicative of actual oral disease state and may be of value for the surveillance of oral diseases when clinical measures are unattainable. In multivariable prediction modeling, these subjective measures had low PPVs thus limiting the generalizability of our findings. Nonetheless, validation and refinement of these constructs in other populations is warranted.

A review of the PERFORMS scheme in breast screening.

This review details the aetiology of the PERFORMS self-assessment scheme in breast screening, together with its subsequent development, current implementation and future function. The purpose of the scheme is examined and the importance of its continuing role in a changing screening service described, together with current evolution.

Team performance training for medical students: Low vs high fidelity simulation

ObjectivesThe aim of this study is to evaluate a simulation-based team performance course for medical students and compare its low- and high-fidelity components. Study designThis is a prospective crossover observational study. Groups participated in one low- and one high-fidelity session twice. Low-fidelity scenarios included management of an emergency case on a simulated-patient, whereas high-fidelity scenarios constituted of multiple-trauma cases where simulated-patients wore a hyper-realistic suit. Team performance was assessed objectively, using the TEAM™ tool, and subjectively using questionnaires. Questionnaires were also used to assess presence levels, stress levels and evaluate the course. ResultsParticipants’ team performance was higher in the low-fidelity intervention as assessed by the TEAM™ tool. An overall mean increase in self-assessed confidence towards non-technical skills attitudes was noted after the course, however there was no difference in self-assessed performance between the two interventions. Both reported mean stress and presence levels were higher for the high-fidelity module. Evaluation scores for all individual items of the questionnaire were ≥4.60 in both NTS modules. Students have assessed the high-fidelity module higher (4.88 out of 5, SD = 0.29) compared to low-fidelity module (4.74 out of 5, SD = 0.67). ConclusionsBoth the low- and high-fidelity interventions demonstrated an improvement in team performance of the attending medical students. The high-fidelity intervention was more realistic, yet more stressful. Furthermore, it proved to be superior in harvesting leadership, teamwork and task management skills. Both modules were evaluated highly by the students, however, future research should address retention of the taught skills and adaptability of such interventions.

Socio-cultural and governance foundations of successful income-generating groups in pastoral societies: Evidence from northern Kenya

ABSTRACT Many community groups in rural Africa malfunction or collapse after external support has ended. The use of non-consultative and non-contextual approaches in the establishment and evaluation of community groups has been associated with limited understanding of group functionality. This paper uses the perspectives of group members to identify social and governance factors contributing to the performance of pastoral income-generating groups. Self-assessment of performance was done with 153 groups followed by 18 semi-structured and 10 to 18 in-depth interviews with well-functioning groups. The results explain and contextualize the importance of specific member characteristics with regard to combining capabilities and resources to increase collective action options of the groups. Group members modified externally provided guidelines on group governance to conform them to traditional governance practices. These insights emphasize the importance of knowledge on socio-cultural norms and practices, and the consideration of experiences and perceptions of community members when establishing community groups.

Experimental evidence that matching habitat choice drives local adaptation in a wild population.

Matching habitat choice is a unique, flexible form of habitat choice based on self-assessment of local performance. This mechanism is thought to play an important role in adaptation and population persistence in variable environments. Nevertheless, the operation of matching habitat choice in natural populations remains to be unequivocally demonstrated. We investigated the association between body colour and substrate use by ground-perching grasshoppers (Sphingonotus azurescens) in an urban mosaic of dark and pale pavements, and then performed a colour manipulation experiment to test for matching habitat choice based on camouflage through background matching. Naturally, dark and pale grasshoppers occurred mostly on pavements that provided matching backgrounds. Colour-manipulated individuals recapitulated this pattern, such that black-painted and white-painted grasshoppers recaptured after the treatment aggregated together on the dark asphalt and pale pavement, respectively. Our study demonstrates that grasshoppers adjust their movement patterns to choose the substrate that confers an apparent improvement in camouflage given their individual-specific colour. More generally, our study provides unique experimental evidence of matching habitat choice as a driver of phenotype-environment correlations in natural populations and, furthermore, suggests that performance-based habitat choice might act as a mechanism of adaptation to changing environments, including human-modified (urban) landscapes.

Assessment of residential institute foodservice using Kano categorization and importance–performance analysis

PurposeIn this article, we identify various foodservice-related attributes that are important for undergraduate students residing in hostels and avail service from specific foodservice providers. We also investigate the performance of attributes to determine areas where the foodservice providers should maintain a high performance or where improvement is required.Design/methodology/approachWe apply the Kano methodology to design the questionnaire for 24 different attributes. For each attribute, we construct three questions; namely, functional type, dysfunctional type, and performance of the hostel foodservice. We collect a total of 317 responses. We use multiple methods to determine the dominant category. Finally, combining the values of these methods, we study relative positions of the attributes in the importance–performance grid.FindingsBased on the Kano categorization, quality-related attributes are most important, followed by hygiene, comfort, availability, variety, and time, in the descending order. The gender of the respondent plays an important role in categorization of some attributes. Using the importance–performance analysis, we identify the attributes where the foodservice provider should maintain a high performance or where improvement is required. Improvements in some attributes are difficult due to foodservice provider's self-assessment of high performance or high difficulty for improvement.Originality/valueIn this study, we examine the importance of various foodservice attributes among undergraduate residential students. We combine multiple methods of Kano categorization to compute importance values of the attributes. We also investigate the reasons behind the gap between student's and foodservice manager's perception of the performance of these attributes.

Self-Assessments of Cognitive Performance in Schizophrenia: The Role of Impaired Momentary Judgement

Self-Assessments of Cognitive Performance in Schizophrenia: The Role of Impaired Momentary Judgement

Acute effects of oxytocin in music performance anxiety: a crossover, randomized, placebo-controlled trial.

Individuals with music performance anxiety (MPA) present physical, behavioral, and cognitive manifestations of anxiety, in addition to information processing deficits, especially in facial emotion recognition (FER). To assess the effects of a single dose of intranasal oxytocin (24IU) on FER in a sample of musicians with high and low MPA (primary outcome), as well as indicators of mood/anxiety and self-assessed performance (secondary outcomes). Crossover, randomized, double-blind, placebo-controlled trial involving 43 male musicians with different levels of MPA. Participants completed a static facial emotion recognition task and self-rated mood and performance scales. Data were analyzed using ANOVA 2 × 0 for crossover trials and the Omnibus test (measure of separability between intervention and carryover effects). Only musicians with high MPA treated with oxytocin had a higher accuracy in the recognition of happiness (p < 0.03; d > 0.72). No effects of oxytocin were found on mood indicators or on self-perceived performance, regardless of MPA level. The results indicate possible benefits of the acute treatment with oxytocin in MPA, which may improve the management of this common and disabling condition that affects professional musicians. The appropriate perception of positive feedback may increase confidence and feelings of social acceptance, reducing symptoms associated with the condition. The lack of effects on mood/anxiety and cognition may be explained by the context-dependent characteristic of the effects of oxytocin, since the experiment did not represent an actual situation of social threat. Brazilian Clinical Trials Registry (Registro Brasileiro de Ensaios Clínicos): No. RBR-9cph2q.

The effectiveness of an operating room etiquette video on medical student comfort in the gynecologic operating room

Background: Medical students spend a large portion of their obstetrics and gynecology (OB/GYN) rotation in the operating room (OR). We identified a deficit in appropriate OR orientation and created a 10-min video reviewing OR etiquette and fundamental skills. Our primary aim was to investigate the effect of this video on medical students' comfort and self-assessed performance in the gynecologic OR. Our secondary aim was to examine if OR personnel rated students' performance higher 8 months after video introduction. Materials and Methods: A prospective, cohort study of 71 3rd- and 4th-year medical students participating in the core OB/GYN clerkship at the University of Pittsburgh Medical Center (UPMC). All medical student participants watched the video once during their clerkship orientation and had continuous online access. Participants completed a pre- and posttest survey assessing their comfort with various OR tasks. After each OR day, participants completed a brief self-assessment of their OR performance. OR staff were surveyed on medical student performance before and after video implementation. Data were analyzed using descriptive statistics, the signed-rank test, and Fisher's exact test via SAS 9.4 (SAS Institute, Inc., Cary, NC, USA). Results: Most students reported improvement on the daily self-assessment. Students without prior surgical experience demonstrated greater improvement in comfort with most OR tasks. OR staff perception of medical students changed favorably after video implementation in several domains. Conclusions: A brief video detailing OR etiquette and fundamental skills is an easily implemented resource to clarify OR tasks that often produce unnecessary anxiety for students. Improved OR staff perception of medical student performance may help streamline OR functioning.

Individual and job-related determinants of bias in performance appraisal: The case of middle management in health care organizations.

Accountable care has changed organizational models adopted by health care organizations profoundly and, consequently, the skill set required for doctor-managers who have become middle managers and must deal with the operational management of their units. Doctor-managers must carry out clinical tasks as well as tasks related to budgeting, goal setting, and performance evaluation. The performance evaluation bias, defined as the misalignment between a ward unit's objective performance (as assessed by technical bodies or agencies) and self-assessed performance by the head of the unit, may have serious consequences for individuals and organizations. The aim of this study was to identify determinants of performance appraisal bias based on the mismatch between self-reported and official performance data. Specifically, we analyzed the role played by managerial behavior, training, engagement, and perceived organizational support at the individual level, as well as the particular unit's task diversity, complexity, and predictability. We collected primary and secondary data referable to a population of ward unit heads in the Italian National Health Service. A linear regression model predicting performance appraisal bias was employed. High levels of engagement and perceived organizational support were associated with reduced performance appraisal bias, whereas high levels of predictability and task diversity were associated with increased degree of error. Doctor-managers attending training programs in health care management and ward unit task complexity did not affect bias significantly. Policy makers and hospital managers should provide heads of units with tools that enable them to conduct ongoing monitoring and accurate appraisal of performance. Doctor-manager performance appraisal bias may be diminished by a perception of having support of the organization and direct superiors. Training programs can be revised to incorporate performance appraisal, and good performance may be incentivized with rewards.

The WRITE Stuff: A Rural Longitudinal Integrated Clerkship Addresses Workforce Needs

Introduction:&#x0D; The University of Washington School of Medicine has six campuses in the five state WWAMI (Washington, Wyoming, Alaska, Montana and Idaho) region. The WRITE (WWAMI Rural Integrated Training Experience) program is a 22 to 24 week long rural longitudinal integrated clerkship experience offered to medical students in their clinical phase (third year) of training. This program seeks to meet the rural workforce needs of the WWAMI region by increasing the number of medical students going into primary care. Critics of LIC’s have expressed concern about overall quality control of the more remote educational experience and the lack of specialty specific teaching. The aim of this study was to compare medical school and PGY-1 performance of WRITE and Non-WRITE students while determining how well each cohort is meeting the regional workforce needs.&#x0D; Methods:&#x0D; The study group was all UWSOM students who matriculated from 2009 to 2013, advanced to graduation, and subsequently matched to a residency through the National Residency Match Program. WRITE and non-WRITE cohorts were compared for USMLE step 1 and 2 scores, MSPE (Medical Student Performance Evaluation) key word, and self and program director assessments in the first year of residency. The match results of the two cohorts were also compared to determine the proportions entering primary care residencies. Finally, for both cohorts the specialty choice at matriculation was compared with the match results. Descriptive statistics were used to test the comparisons.&#x0D; Results:&#x0D; The medical school performance of the WRITE and Non-WRITE cohorts was equivalent in all metrics (USMLE Step 1 and 2, MSPE key word, self and program director assessment of performance in the first year of residency). WRITE students were significantly more likely to match into primary care (67.6% vs 48.3%, p&lt;0.001) overall and, in particular, Family Medicine as their specialty (40% vs 14.3%, p&lt;0.001). WRITE students were also more likely to match into the same specialty that they indicated on the UWSOM matriculation survey. For Family Medicine the loss of fidelity between matriculation and match among WRITE students was 3% (43.4 - 40.4) and among Non-WRITE students, it was 6.3% (20.6 - 14.3).&#x0D; Conclusions:&#x0D; Performance outcomes of the WRITE program are equivalent to a traditional block curriculum. However, the WRITE cohort is significantly more likely to go into primary care fields, especially family medicine and is more likely to stay with the declared specialty at matriculation. Medical schools that seek to increase the number of students going into primary care may benefit from adopting a similar model.

Activities of daily living in Parkinson's disease: Time/gender perspective.

The objectives of this study were to explore the changes in the activities of daily living (ADL) in persons with Parkinson's disease (pwPD) over time and to investigate possible differences in ADL performance between men and women with PD. One hundred twenty-nine persons (76 men) with a clinically established PD self-assessed their ADL performance from the time of diagnosis up to 8years follow-up using the ADL taxonomy. Other demographic and clinical data (motor state, cognition, depression) were also collected and subjected to further analysis. Nine of 12 domains in the ADL taxonomy showed a change over time (Eating and Drinking [P=.009], Mobility [P<.001], Toilet activities [P=.031], Dressing [P<.001], Personal hygiene [P<.001], Communication [P<.001], Cooking [P=.001], Shopping [P<.001] and Cleaning [P<.001]). In addition to time, two domains, (Shopping [P=.007] and Cleaning [P=.027]) also showed an effect of gender with worse scores in women. The nine ADL domains showing effect of time, showed temporary improvement at 12months follow-up, most probably due to dopaminergic medication. All nine domains deteriorated at later follow-up. As expected, there was deterioration in self-assessed performance in the majority od ADL domains over time. Women assessed their ADLs worse in two domains (Shopping and Cleaning) probably reflecting a general gender-related activity pattern rather than being a PD-specific finding.