Lynn David J, Holzer Charles, O'Neill Patrick
Department of Psychiatry, Thomas Jefferson University, 1020 Sansom Street Suite 1652, Philadelphia, Pennsylvania 19107-5004, USA.
Adv Health Sci Educ Theory Pract. 2006 Feb;11(1):51-60. doi: 10.1007/s10459-005-5473-4.
Some researchers have seen the capacity for self-assessment in trainees as a special skill, and some reports have concluded that this skill is positively and crucially correlated with academic competence. Thus, it is believed that those trainees who are most deficient in knowledge are least likely to be aware of their limitations. Other researchers have emphasized the impact of statistical regression and other technical considerations in the studies, which have led to these conclusions. Our study used a relative-ranking design to measure the accuracy of self-assessments of both strengths and weaknesses in psychiatry residents. We analyzed the relationships between indices of self-assessment accuracy and other resident characteristics, particularly current academic strength as measured by a standard test of psychiatric knowledge. A total of 56 residents in two general psychiatry programs evaluated their performance on the Psychiatry Resident in Training Examination by estimating the rank order of their scores in the 11 psychiatry subject areas. For each resident, actual examination results were then used to generate measures of the accuracy of the identification of strengths and weaknesses. Residents' identifications of their strengths and weaknesses were significantly more accurate than chance levels. Strengths and weaknesses were identified with roughly equal proficiency, and accuracy in these assessments was not correlated to any of the following variables: academic competence as measured by examination raw scores, postgraduate year, gender, international vs. American medical education, program membership, or age. Our results do not support the hypothesis that trainees who show the least academic mastery also make the most inaccurate self-assessments. In addition, we found no resident characteristics that accounted for variation in self-assessment accuracy.
一些研究人员将实习生的自我评估能力视为一项特殊技能，一些报告得出结论，这项技能与学术能力呈正相关且至关重要。因此，人们认为那些知识最欠缺的实习生最不可能意识到自己的局限性。其他研究人员强调了统计回归和研究中的其他技术因素对得出这些结论的影响。我们的研究采用相对排名设计来衡量精神科住院医师对自身优势和劣势自我评估的准确性。我们分析了自我评估准确性指标与其他住院医师特征之间的关系，特别是通过精神病学知识标准测试衡量的当前学术实力。两个普通精神科项目中的56名住院医师通过估计自己在11个精神病学学科领域的分数排名顺序，评估了他们在《精神科住院医师培训考试》中的表现。然后，对于每位住院医师，利用实际考试结果生成对其优势和劣势识别准确性的衡量指标。住院医师对自身优势和劣势的识别明显比随机水平更准确。对优势和劣势的识别熟练度大致相同，并且这些评估的准确性与以下任何变量均无关联：以考试原始分数衡量的学术能力、研究生年级、性别、国际医学教育与美国医学教育、项目成员身份或年龄。我们的结果不支持以下假设：学术掌握程度最低的实习生自我评估最不准确。此外，我们没有发现任何住院医师特征能够解释自我评估准确性的差异。
