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 2008; 28(1):47-54 RESEARCH ARTICLE "Directed" Self-Assessment: Practice and Feedback Within a Social Context Sargeant J, Mann K, Van der Vleuten C, Metsemakers J A b s t r a c t Introduction: Accurate self-assessment appears to be difficult and, some would propose, even impossible. Recent reviews suggest that peer assessment may be more accurate and that multisource feedback (MSF) may inform self-assessment. We had conducted a series of studies of family physicians in an MSF program including assessments from patients, medical colleagues, and coworkers and self-assessment. Using this body of research, this article explores self-assessment within the social context of multisource feedback and investigates the influence of feedback from peers and others upon self-assessment. Methods: This is a review article in which we synthesized findings of the series of studies with respect to selfassessment, used conclusions to propose a model for self-assessment within a social context, and suggest practical and research implications. Results: Physicians compared peers’ and others’ assessment feedback with global self-perceptions of performance. Negative feedback, especially from medical colleagues, that was inconsistent with self-perceptions was not readily reconciled with self-assessments. Multiple internal and environmental factors influenced reconciliation and assimilation of negative feedback. Reflection upon feedback and self-perceptions appeared to be instrumental to reconciliation, and reflection could be facilitated. Discussion: We propose a model of “directed” self-assessment to facilitate the integration of external feedback, especially negative feedback, with self-perceptions and enable its use for practice improvement. Implications for education and research include increasing understanding of ways physicians assimilate external feedback and of the role of educators as facilitators of “directed” self-assessment and self-learning to assist physicians in integrating external feedback. Lessons for Practice External assessment feedback that is inconsistent with self-perceptions of performance may not be readily reconciled with self-perceptions nor subsequently used for practice improvement and learning. Ensuring that external assessment feedback is specific and credible is key to enhancing reconciliation with self-assessments and subsequent use. Facilitating reflection upon feedback and its relationship and relevance to one’s practice can also enhance reconciliation of negative external feedback with selfassessments. Consider directed self-assessment occurring within a social environment as a model for self-assessment in the “real world,” ie, a model in which self-assessment is influenced by external feedback and internal and external factors and mediated by facilitation for learning and change.
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