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Clinical skills in junior medical officers: a comparison of self‐reported confidence and observed competence
Author(s) -
Barnsley Les,
Lyon Patricia M,
Ralston Susan J,
Hibbert Emily J,
Cunningham Ilona,
Gordon Fiona C,
Field Michael J
Publication year - 2004
Publication title -
medical education
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.776
H-Index - 138
eISSN - 1365-2923
pISSN - 0308-0110
DOI - 10.1046/j.1365-2923.2004.01773.x
Subject(s) - competence (human resources) , confidence interval , psychology , self confidence , medical education , medicine , self assessment , family medicine , social psychology
Background 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. Aims and hypothesis We aimed to determine the relationship between self‐reported confidence and observed competence for a number of routine, procedural clinical skills. Methods 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. Results 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. Conclusions 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.