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Self-Monitoring Accuracy over Time for a Complex Diagnostic Skill
Wolf E Hautz1, Thimo Marcin1, Stefan K Schauber2
1Department of Emergency Medicine, Inselspital University Hospital Bern, University of Bern, Bern, Switzerland.
Perspectives on Medical Education
|May 18, 2026
Summary
Self-monitoring accuracy in medical students’ ultrasound skills declined six months post-training. However, the study suggests improved self-monitoring accuracy at delayed retesting, indicating it is not a stable trait.
Area of Science:
- Medical Education
- Skill Acquisition
- Psychomotor Performance
Background:
- Self-monitoring accuracy is crucial for task performance but its long-term development is understudied.
- This study investigates the longitudinal changes in self-monitoring accuracy during complex clinical task performance.
Purpose of the Study:
- To explore the long-term development of self-monitoring accuracy in medical students performing a complex clinical task.
- To assess changes in performance and confidence over a six-month follow-up period.
Main Methods:
- 141 medical students without prior ultrasound skills were assessed immediately after training (T1) and at six-month follow-up (T2) using Objective Structured Clinical Examinations (OSCEs).
- Expert skill evaluation and self-reported confidence were recorded at each station.
- Linear mixed models analyzed changes in performance and confidence, and the influence of training, demographics, and performance on confidence.
Main Results:
- Performance scores decreased from T1 (median 36.0/50) to T2 (median 34.3/50).
- Self-reported confidence levels also decreased from T1 (median 3/5) to T2 (median 2.8/5), generally correlating with skill decline.
- Male students reported higher confidence; training positively impacted confidence and performance.
Conclusions:
- Self-monitoring accuracy is dynamic and changes over time, not a fixed trait.
- Results indicate potential improvement in self-monitoring accuracy at delayed retesting.
- Further research with finer-grained assessment and longer follow-up is recommended to understand inter-individual differences.
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