Graves Lisa, Lalla Leonora, Young Meredith
Professor in the Department of Family and Community Medicine in the Homer Stryker MD School of Medicine at Western Michigan University in Kalamazoo.
Assistant Professor and Director of Undergraduate Education in the Department of Family Medicine at McGill University in Montreal, Que.
Can Fam Physician. 2017 Apr;63(4):e238-e243.
To examine the relationship between objective assessment of performance and self-rated competence immediately before and after participation in a required summative family medicine clerkship objective structured clinical examination (OSCE).
Learners rated their competence (on a 7-point Likert scale) before and after an OSCE along 3 dimensions: general, specific, and professional competencies relevant to family medicine.
McGill University in Montreal, Que.
All 168 third-year clinical clerks completing their mandatory family medicine rotation in 2010 to 2011 were invited to participate.
Self-ratings of competence and objective performance scores were compared, and were examined to determine if OSCEs could be a "corrective" tool for self-rating perceived competence (ie, if the experience of undergoing an assessment might assist learners in recalibrating their understanding of their own performance).
A total of 140 (83%) of the third-year clinical clerks participated. Participating in an OSCE decreased learners' ratings of perceived competence (pre-OSCE score = 4.9, post-OSCE score = 4.7; = 4.2; < .05). Learners' mean self-rated competence for all categories of behaviour (before and after) showed no relationship to OSCE performance ( < 0.12 and > .08 for all), nor did ratings of station-relevant competence (before and after) ( < 0.19 and > .09 for all). Ratings of competence before and after the OSCE were correlated for individual students ( > 0.40 and < .001 for all).
After the OSCE, students' self-ratings of perceived competence had decreased, and these ratings had little relationship to actual performance, regardless of the specificity of the rated competency. Discordance between perceived and actual competence is neither novel nor unique to family medicine. However, this discordance is an important consideration for the development of competency-based curricula.
探讨在参加必修的总结性家庭医学临床实习客观结构化临床考试（OSCE）之前和之后，客观绩效评估与自我评定能力之间的关系。
学习者在OSCE前后，沿3个维度对其能力进行评分（采用7分李克特量表）：与家庭医学相关的一般能力、特定能力和专业能力。
魁北克省蒙特利尔市的麦吉尔大学。
邀请了2010年至2011年完成强制性家庭医学轮转的所有168名三年级临床实习生参加。
比较能力的自我评定与客观绩效分数，并进行检查以确定OSCE是否可以作为自我评定感知能力的“校正”工具（即，接受评估的经历是否可能帮助学习者重新校准他们对自身表现的理解）。
共有140名（83%）三年级临床实习生参与。参加OSCE降低了学习者对感知能力的评分（OSCE前分数=4.9，OSCE后分数=4.7；P=4.2；P<0.05）。学习者对所有行为类别（前后）的平均自我评定能力与OSCE表现无关（所有P<0.12且P>0.08），与站点相关能力的评分（前后）也无关（所有P<0.19且P>0.09）。OSCE前后的能力评分在个体学生中具有相关性（所有P>0.40且P<0.001）。
OSCE后，学生对感知能力的自我评定有所下降，且这些评分与实际表现关系不大，无论评定能力的具体程度如何。感知能力与实际能力之间的不一致在家庭医学中既不新鲜也不独特。然而，这种不一致是基于能力的课程开发的一个重要考虑因素。
