Barnsley Les, Lyon Patricia M, Ralston Susan J, Hibbert Emily J, Cunningham Ilona, Gordon Fiona C, Field Michael J
Department of Medical Education, University of Sydney, New South Wales 2006, Australia.
Med Educ. 2004 Apr;38(4):358-67. doi: 10.1046/j.1365-2923.2004.01773.x.
The intern year is a key time for the acquisition of clinical skills, both procedural and cognitive. We have previously described self-reported confidence and experience for a number of clinical skills, finding high levels of confidence among Australian junior doctors. This has never been correlated with an objective measure of competence.
We aimed to determine the relationship between self-reported confidence and observed competence for a number of routine, procedural clinical skills.
A group of 30 junior medical officers in their first postgraduate year (PGY1) was studied. All subjects completed a questionnaire concerning their confidence and experience in the performance of clinical skills. A competency-based assessment instrument concerning 7 common, practical, clinical skills was developed, piloted and refined. All 30 PGY1s then completed an assessment using this instrument. Comparisons were then made between the PGY1s' self-reported levels of confidence and tutors' assessments of their competence.
A broad range of competence levels was revealed by the clinical skills assessments. There was no correlation between the PGY1s' self-ratings of confidence and their measured competencies.
Junior medical officers in PGY1 demonstrate a broad range of competence levels for several common, practical, clinical skills, with some performing at an inadequate level. There is no relationship between their self-reported level of confidence and their formally assessed performance. This observation raises important caveats about the use of self-assessment in this group.
实习年是获取临床技能（包括操作技能和认知技能）的关键时期。我们之前曾描述过澳大利亚初级医生对多种临床技能的自我报告的信心和经验，发现他们的信心水平较高。但这从未与能力的客观衡量标准相关联。
我们旨在确定自我报告的信心与多种常规操作临床技能的观察到的能力之间的关系。
对一组30名处于研究生一年级（PGY1）的初级医疗人员进行了研究。所有受试者都完成了一份关于他们在临床技能操作方面的信心和经验的问卷。开发、试用并完善了一种基于能力的评估工具，该工具涉及7种常见的实用临床技能。然后，所有30名PGY1使用该工具完成了一项评估。随后对PGY1自我报告的信心水平与导师对他们能力的评估进行了比较。
临床技能评估显示出广泛的能力水平范围。PGY1的自我信心评分与他们的实际能力之间没有相关性。
PGY1的初级医疗人员在几种常见的实用临床技能方面表现出广泛的能力水平范围，有些人的表现水平不足。他们自我报告的信心水平与他们正式评估的表现之间没有关系。这一观察结果对该群体中自我评估的使用提出了重要的警示。
