Low performing students have insightfulness when they reflect-in-action

Area of Science:

• Medical Education
• Cognitive Psychology
• Clinical Reasoning

Background:

• Accurate self-monitoring, including certainty of correctness, is vital for clinicians to prevent medical errors.
• Previous self-assessment studies used methods less authentic to clinical practice, showing poorer accuracy in less experienced individuals.
• This study explores the relationship between response certainty and correctness using practice-authentic assessment methods.

Purpose of the Study:

• To investigate how the certainty of medical students' responses correlates with their correctness on a progress test.
• To determine if this relationship differs based on student experience and performance levels.
• To assess the impact of practice-authentic assessment descriptors on self-monitoring accuracy.

Main Methods:

• Medical students from Years 2-5 participated in two progress test iterations.
• Students indicated their certainty for each response.
• Analyses correlated response correctness with certainty, test iteration, student year, and performance level.

Main Results:

• The likelihood of a correct response significantly increased with higher student certainty.
• This positive correlation between certainty and correctness was observed across all student groups, including those with less experience and lower performance.
• The findings held true even when accounting for student year and ability level.

Conclusions:

• Contrary to prior research, increasing certainty consistently correlated with increased correctness, even in less experienced and lower-performing students.
• This suggests that assessment methods authentic to clinical practice, which encourage reflection-in-action, improve the accuracy of self-assessment.
• The study highlights the importance of using practice-relevant tools to measure and potentially improve clinical self-monitoring skills.