Journal of Continuing Education in the Health Professions



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CURRENT ISSUE BACK ISSUES SUBSCRIBE ADVERTISE ABOUT JCEHP FOR AUTHORS JCEHP AWARD SEARCH		Volume 28 (1) Volume 28, Issue 1, Winter 2008 J Contin Educ Health Prof 2007; 28(1):20-24 FOUNDATIONS OF CONTINUING EDUCATION Making Self-Assessment More Effective Galbraith RM, Hawkins RE, Holmboe ES A b s t r a c t Self-assessment has been held out as an important mechanism for lifelong learning and self-improvement for health care professionals. However, there is growing concern that individual learners often interpret the results inaccurately. This idea has led to skepticism that self-assessment in its current form can ever be truly useful for lifelong professional development. We examine the proposal that self-assessment can and should be made more effective. First, relevance should be improved. The process should be tied more explicitly to the individual’s actual practice profile, rather than being loosely relevant to broader constructs around the permitted scope of practice (eg, certification or licensure). In addition, self-assessment should include not only knowledge and reasoning but also what is done every day in practice, thereby broadening from competence in simulated settings to performance in real settings. Second, the impact of self-assessment should be substantially strengthened by periodic external validation of self-assessment results, together with goals set as a result and plans for further improvement. This offers to the individual the very tangible benefit of satisfying external mandates (eg, licensure and certification). In addition, impact should be reinforced by linking the results of self-assessment to subsequent learning activities including Continuing Medical Education (CME). Although these enhancements individually may not cure all of what ails self-assessment, they might ensure greater effectiveness for the purposes of lifelong learning. Lessons for Practice Effective self-assessment should be based on a clear understanding of what the health care professionals actually does in their practice. Self-assessment should include measures of knowledge and reasoning but also of other domains (behaviors, skills, processes of care, outcomes). The individual learner should regularly obtain external validation of his or her selfassessment activities, both by using feedback and comparative data from other physicians with like practice and by sharing results with peers. Improvement activities including CME should be selected in part on the basis of the results of self-assessment.
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