Military and Emergency Medicine and Medicine, Uniformed Services University of Health Sciences, Bethesda, Maryland, USA.
Center for Health Professions Education, Uniformed Services University of Health Sciences, Bethesda, Maryland, USA.
Med Educ. 2023 Sep;57(9):795-806. doi: 10.1111/medu.15023. Epub 2023 Mar 1.
Physicians and physicians-in-training have repeatedly demonstrated poor accuracy of global self-assessments, which are assessments removed from the context of a specific task, regardless of any intervention. Self-monitoring, an in-the-moment self-awareness of one's performance, offers a promising alternative to global self-assessment. The purpose of this scoping review is to better understand the state of self-monitoring in graduate medical education.
We performed a scoping review following Arksey and O'Malley's six steps: identifying a research question, identifying relevant studies, selecting included studies, charting the data, collating and summarising the results and consulting experts. Our search queried Ovid Medline, Web of Science, PsychINFO, Eric and EMBASE databases from 1 January 1999 to 12 October 2022.
The literature search yielded 5363 unique articles. The authors identified 77 articles for inclusion. The search process helped create a framework to identify self-monitoring based on time and context dependence. More than 20 different terms were used to describe self-monitoring, and only 13 studies (17%) provided a definition for the equivalent term. Most research focused on post-performance self-judgements of a procedural skill (n = 31, 42%). Regardless of task, studies focused on self-judgement (n = 66, 86%) and measured the accuracy or impact on performance of self-monitoring (n = 41, 71%). Most self-monitoring was conducted post-task (n = 65, 84%).
Self-monitoring is a time- and context-dependent phenomenon that seems promising as a research focus to improve clinical performance of trainees in graduate medical education and beyond. The landscape of current literature on self-monitoring is sparse and heterogeneous, suffering from a lack of theoretical underpinning, inconsistent terminology and insufficiently clear definitions.
医生和医学生在进行全球自我评估时，准确性一再较差，而这种评估是脱离特定任务背景的评估，无论是否进行了干预。自我监测是对自身表现的即时自我意识，是对全球自我评估的一种很有前景的替代方法。本范围综述的目的是更好地了解研究生医学教育中自我监测的现状。
我们按照 Arksey 和 O'Malley 的六个步骤进行了范围综述：确定研究问题、确定相关研究、选择纳入的研究、绘制数据图表、整理和总结结果以及咨询专家。我们的搜索查询了 Ovid Medline、Web of Science、PsychINFO、Eric 和 EMBASE 数据库，检索时间为 1999 年 1 月 1 日至 2022 年 10 月 12 日。
文献检索产生了 5363 条独特的文章。作者确定了 77 篇文章纳入。搜索过程有助于创建一个基于时间和上下文依赖性来识别自我监测的框架。有 20 多个不同的术语被用来描述自我监测，只有 13 项研究（17%）提供了等效术语的定义。大多数研究集中在程序性技能的事后自我判断上（n=31，42%）。无论任务如何，研究都集中在自我判断上（n=66，86%），并衡量自我监测对性能的准确性或影响（n=41，71%）。大多数自我监测是在任务结束后进行的（n=65，84%）。
自我监测是一种时间和上下文相关的现象，作为研究生医学教育和更广泛领域提高学员临床表现的研究重点，似乎很有前景。当前关于自我监测的文献景观稀少且异质，缺乏理论基础、术语不一致且定义不够明确。
