Informed self-assessment during the transition to medical school: a longitudinal narrative study
Jenny McDonald1, Samantha Ryan2, Sylvia Heeneman3
1School of Medicine, Western Sydney University, Penrith South, New South Wales, Australia jenny.mcdonald@westernsydney.edu.au.
BMJ Open
|December 29, 2022
Summary
Medical students’ informed self-assessment (ISA) narratives evolve during their first 18 months. Early uncertainty shifts to confidence based on clinical competence, not just grades or peer comparison.
Area of Science:
- Medical Education
- Psychology of Learning
Background:
- Medical students face significant adaptation challenges during their transition to medical school.
- Developing effective self-regulated learning and informed self-assessment (ISA) skills is crucial for academic success.
Purpose of the Study:
- To explore the evolving nature of medical students' narratives of informed self-assessment (ISA) over their initial 18 months of study.
- To understand the personal and environmental factors influencing these changes.
Main Methods:
- A longitudinal qualitative study involving seven first-year medical students.
- Data collected through 13.5 hours of interviews and 12 written reflections across five time points over 18 months.
- Analysis informed by Situated Cognition Theory.
Main Results:
- Initially, self-assessments were influenced by external factors like exam results and peer comparison, alongside personal anxieties.
- Over time, a stronger sense of belonging reduced fear of failure and peer competition.
- Self-assessments increasingly incorporated clinical skills and knowledge related to professional competence.
Conclusions:
- The factors influencing medical students' ISA shift significantly during the transition to medical school.
- Developing a sense of belonging and demonstrating clinical competence become more important drivers than peer comparison or exam performance.
- Formative assessments, peer interaction, and early clinical experiences are vital for enhancing ISA skills.
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