Faculty Versus Resident Self-Assessment Using Pathology Milestones: How Aligned Are We?

Area of Science:

• Medical Education
• Physician Training
• Self-Assessment Accuracy

Background:

• Physician competence requires accurate self-assessment skills.
• Previous research indicates medical trainees may struggle with accurate self-assessment.
• Pathology Milestones (PM) data provides a framework for evaluating trainee competency.

Purpose of the Study:

• To investigate discrepancies between resident self-evaluations and Clinical Competency Committee (CCC) ratings.
• To analyze how these discrepancies vary by sex, postgraduate year (PGY), evaluation timing, and specific competency categories.
• To explore the relationship between discrepancies and Residency In-Service Examination (RISE) scores.

Main Methods:

• Retrospective analysis of PM evaluation scores from 2016-2019 for 23 pathology residents.
• Data collected twice annually, comparing resident self-ratings against CCC ratings.
• Discrepancy scores calculated by subtracting CCC scores from self-evaluation scores.

Main Results:

• No significant sex-based differences in self-assessment discrepancies were observed.
• Significant differences in discrepancy scores were found across postgraduate years (PGY), with early-year residents overrating and later-year residents underrating themselves.
• Residents tended to underrate themselves in January evaluations and overrate in July evaluations.
• Systems-Based Practice (SBP) showed lower self-ratings compared to CCC, while Professionalism (PRO) showed higher self-ratings.
• Higher RISE scores correlated with improved self- and CCC-based scoring.

Conclusions:

• Significant discrepancies exist between resident self-assessment and expert evaluation in pathology training.
• Training year and evaluation timing are key factors influencing self-assessment accuracy.
• Understanding these discrepancies can guide targeted interventions, such as curriculum refinement and clearer competency framework definitions, to enhance physician self-awareness and professional development.