Self-Assessment Versus Peer Assessment of Oncology Communication Skills in Medical Students: A Video-Based Pilot...

Communication of difficult news is a core competency in oncology education. How accurately medical students self-assess their communication performance shapes formative learning and curriculum design.

To examine differences between self-assessment and peer assessment of bad-news communication skills in a video-assisted standardized patient (SP) examination, and to characterize student perceptions of video-based feedback.

A mixed-methods pilot study enrolled 49 third-year medical students (10 examinees, 39 peer assessors) in a mandatory oncology course at a Brazilian federal university. Communication was assessed using a structured ten-domain checklist (10-60 points) informed by the SPIKES protocol, the Calgary-Cambridge Guide, and the MAAS-Global Manual. Checklists were completed before and after video review. Condition effects were quantified using effect sizes (Cohen's dₚ) and 95% confidence intervals. Written qualitative responses underwent categorical content analysis.

All ten examinees rated themselves below the corresponding peer mean (self: 36.5/60; peer: 43.2/60; mean difference = 6.73 points; 95% CI (0.30, 13.16); Cohen's d_p = 0.75). Video review did not alter scores (mean change = - 0.10; 95% CI (- 1.56, 1.36); d_p = 0.05). Qualitative categories identified empathy, SPIKES adherence, and step-by-step video evaluation as the dominant themes. All students rated video-based feedback positively.

In this pilot sample, all ten examinees rated themselves below the corresponding peer mean - a pattern of discrepancy that diverges from the overestimation pattern more commonly reported in international meta-analyses. Video-based feedback was qualitatively valued, with no statistically detectable effect on checklist scores over a single review session. These hypothesis-generating findings warrant larger, instrument-validated studies.