By Brie Holmes, PharmD, PGY1 Pharmacy
Practice Resident, Magnolia Regional Health Center
Healthcare is advancing and expanding at an astounding
rate. Now, more than ever, healthcare professionals must take the initiative to
learn about new technology, diagnoses, and treatment options to provide the
best care to patients.1 Healthcare practice is rooted in trusting
patient/provider relationships, and healthcare professions are expected to
continually expand their knowledge. It is simply not adequate to rely on one’s initial
education and training or the required continuing education hours to stay well informed
about the latest developments.2 Instead, healthcare professionals
must take responsibility and be self-directed learners to remain competent throughout
their career.
Self-assessment methods and the utility of those methods has
been well studied. Research has shown that those who regularly engage in a
self-assessment process have increased academic achievement and workplace
performance.1 Andrade defines self-assessment as “…a process of
formative assessment during which students reflect on and evaluate the quality
of their work and learning, judge the degree to which they reflect explicitly
stated goals or criteria, identify strengths or weaknesses in their work and
revise accordingly.”3 There are other definitions of
self-assessment, but all sources agree that it is a process with the goal of
continuous improvement involving an intrinsic evaluation of one’s knowledge and
performance, recognizing one’s own deficits, and implementing a plan to correct
identified deficits. Because there is a clear expectation for healthcare
professionals to stay up-to-date on new research, there is also an expectation
that healthcare professionals skillfully use self-assessment techniques to
accomplish this. Despite what’s known about effective self-assessment methods
and their benefits, there are numerous studies showing the general inability of
students and healthcare providers alike to accurately assess their knowledge
and skills and, therefore, effectively address deficits. In fact, only 45% of the
studies included in a systematic review of the physician literature showed a
positive relationship between self- and external assessments.3 Not
only is this a disservice to oneself as a professional, but it is also a
disservice to our patients who have trusted us to provide the best care
possible.
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Multiple studies have suggested students and some
providers are not able to correctly assess their learning needs. One possible explanation is that students
have grown accustomed to dependent learning. Historically, evaluation of knowledge
has largely been done using exams. This external form of evaluation often
creates dependent learners who have very little intrinsic consideration or
responsibility. Dependent learning can quickly dissolve motivation to gain
knowledge outside of what will be on an exam and instead encourages
memorization, resulting in a reliance on external motivation and validation.3
This process does not adequately equip students with the necessary skills
required for work after graduation as they are not prepared to take the
initiative to identify their learning needs or to address perceived
deficits. After graduation, there will no longer be someone who will identify
the student’s learning needs or direct them to appropriate learning activities.1
Thus, educators can and should incorporate self-assessments early in the
curriculum to teach students this important skill so that they can apply it in
the real world.5
Developing good self-assessment skills can also improve the
learner’s willingness to accept feedback as well as develop their self-confidence.3
It is well-accepted that self-assessment is a learned skill. It not something that most people “just naturally”
know how to do. Because of this, the Accreditation Council on Pharmacy Education
has stated that self-assessment should be integrated into the pharmacy
curriculum early and continued throughout the curriculum.3
Additionally, the American Medical Association considers self-assessments to be
a vital professional skill and has suggested guided self-assessments be
incorporated at the earliest possible stage in medical training.4 The
key to guiding self-assessments is ensuring the student receives quality
external feedback. Some examples of activities educators could incorporate that
would provide an opportunity for self-assessment coupled with external feedback is an Objective Structured
Clinical Examination (OSCE), particularly if they are videotaped and reviewed
by the student. Problem-based learning
cases and independent learning projects can also be used, whereby students compare
their self-assessment of their performance to external evaluations using rubrics.1,3
If educators want their students to be competent and
successful healthcare professionals who embrace the notion of continuous
professional development, they must instill the importance and benefits of
self-assessments and stimulate increased motivation to engage in the process.3
As research continues to show the clear benefits of self-assessment, accrediting
bodies require health professional programs to include self-assessments. Self-assessment techniques should be
introduced early in curriculums alongside external assessments. This will help students learn the vital skill
of identifying deficits and critically evaluating their work. In this way, students will be better prepared
for post-graduation work and lifelong learning. Furthermore, self-assessments should
prompt students to consider their personal and professional goals while
equipping them with the tools necessary to achieve those goals. Without effective
self-assessment strategies, healthcare professionals will not be adequately
prepared for lifelong learning in a field that is constantly expanding and
changing.
References
1.
Guglielmino
LM. The
case of promoting self-directed learning in formal educational institutions.
South African Education Journal. 2013;10(2):1-18.
2.
Asadoorian J,
Batty, H. An
evidence-based model of effective self-assessment for directing professional
learning. Journal of Dental Education. 2005;69(12):1315-1322.
3.
Motycka CA,
Rose RL, Ried LD, Brazeau G. Self-assessment in
pharmacy and health science education and professional practice. Am J Pharm Educ 2010;74(5) Article 85.
4.
Duffy FD,
Holmboe ES. Self-assessment
in lifelong learning and improving performance in practice. JAMA
2006;296(9):1137-1139. doi: 10.1001/jama.296.9.1137
5.
Adachi C, Tai
JH-M, Dawson P. Academics’
perceptions of the benefits and challenges of self and peer assessment in
higher education. Assessment & Evaluation in
Higher Education.
2017;43(2):294-306. doi:10.1080/02602938.2017.1339775.
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