Self-assessment Accuracy: the influence of gender and year in medical school self assessment Elhadi H. Aburawi, Sami Shaban, Margaret El Zubeir, Khalifa El Zubeir, Sambandam Elango CMHS, UAE University, Al Ain, Abu Dhabi

Introduction Self-assessment is defined as “the involvement of learners in making judgment about whether or not learners-identified standards have been met (Eva & Roger, 2005) Self-assessment and critical self-reflection are considered important aspects of professional medical practice. (GMC, 2013)

Introduction Self-reflection promotes an understanding of one’s own strengths and weaknesses and can lead to deep learning. (Laggett, et al 2012) Self-assessment is an important starting point for reaching one’s full potential since it should motivate ownership and self-regulation of learning. (Sanders, 2012) Female medical students are often less confident and underestimate their performance. (Blanch, et al, 2008)

Introduction Assessment of one's academic and professional capabilities is essential to being an effective self- regulated and self-directed lifelong learner. However, several studies have indicated poor self- assessment capabilities of medical students and practicing physicians.

Introduction Questions have been raised as to whether students can objectively estimate their performance and investigations of the construct has been criticized in the medical education literature as flawed on methodological grounds. (Ward, 2002 & Eva, 2007) Existing research has shown some conflicting results concerning self assessment capabilities across the medical education continuum. (Fitzgerald et al 2000)

Aims To evaluate the self-assessment accuracy among our Junior medical students. To identify characteristics that influence self- assessment accuracy, including year in medical school and gender, perceived preparation, confidence and anxiety. Based on study outcomes we aimed to make recommendations for curriculum interventions assessment designed to assist students in development of self-assessment.

Methods A short, electronic survey of four Likert-scale questions. Preparedness and Confidence, Prediction of mark in the exam and anxiety level both before and after conducting the exam, Table 1.

Table 1: Pre Exam Survey QuestionOptions 1. How prepared are you for this exam? 1. Not prepared at all 2. Somewhat prepared 3. Well prepared 2. How confident are you in passing this exam? 1. Not confident at all 2. Somewhat Confident 3. Very confident 3. What mark range do you think you will achieve in this exam? 1. < 60% % % % % 4. What is your anxiety level? 1. Not Anxious at all 2. Somewhat Anxious 3. Very Anxious

Methods Computers were utilized to conduct the pre and post exam surveys. 235 students chose to participate in the pre exam survey (50% response rate), and 59 students chose to participate in the post exam survey (13% response rate).

Methods The answers to the survey were collected and stored electronically along with the result of the exam. Data were analyzed using SPSS for descriptive statistics, Pearson's correlation coefficient calculations, regression analysis, and t-test.

Results 1 Students expected mark correlated significantly with objectively assessed marks (r = 0.407, p<0.01), Figure 1. However, students grossly overestimate their exam performance with a difference of 14 points (out of 100) between the average actual mark and the students average expected mark.

Figure 1: Correlation between student's expected mark and actual mark

Results 2 Self-assessed pre-examination score range was significantly different between males and females (t- test, p < 0.05) with females expecting higher marks. Older students (2nd year vs 1st year of education) expressed higher levels of anxiety although this did not reach statistical significance (t-test, p = 0.07).

Results 3 There were significant correlations between reported preparedness and expected mark (r = 0.459, p=0.000) Also between reported confidence and expected mark (r = 0.569, p=0.000). Reported anxiety and expected mark were not significantly correlated, Table 2.

Table 2: Correlations between actual mark, prepared, confident, expected mark and anxiety * Correlation is significant at the 0.05 level (2-tailed) ** Correlation is significant at the 0.01 level (2-tailed) Actual MarkPreparedConfidentExpected Mark Preparedr= * Confidentr= ** r= ** Expected Markr= ** r= ** r= ** Anxietyr= 0.008r= r= * r=

Results 4 There was no statistically significant difference between pre and post exam survey scores for those who completed both surveys (59 students). In fact, there was a high correlation between pre and post exam survey results for all four questions, Table 3.

Table 3: Number and percentage of students per question with same, higher and lower responses on the pre vs post exam surveys (n=59). *Significant correlation Question Same Response (%) Higher Response (%) Lower Response (%) Pre Exam Mean Post Exam Mean r P-value Preparation53 (90%)5 (8%)1 (2%) * Confidence42 (71%)10 (17%)7 (12%) * Expected Mark 32 (54%)11 (19%)16 (27%) * Anxiety38 (64%)7 (12%)14 (24%) * Total165 (70%)33 (14%)38 (16%)

Results 5 The group of students who took the pre exam survey did significantly better on the exam compared to the group that did not take this survey (t-test, p=0.028), Table 4.

Table 4: Comparison of average mark for those who took the pre exam survey vs those who chose not to take this survey. GroupNMean MarkSDt-test Took pre exam survey * Did not take pre exam survey

Limitations Low response rate in terms of post exam self-assessment survey. The data yielded is small but will be enough to indicate recommendations to encourage faculty to improve assessment feedback, assisting students to practice self- reflection, self-awareness, and self-assessment skill. The study relied on quantitative data and used a self- assessment rating scale which has not been validated.

Conclusion In keeping with other published studies; ours indicated that medical students are moderate to poor self assessors. Our results showed that self-assessment of examination performance is not predictive of objectively determined outcomes among medical students.

Conclusion Contrary to previous findings in our setting, females were more confident in their abilities but less accurate self-assessors than males. There were no significant differences in self-assessment accuracy in senior vs junior students and senior students were more anxious than their junior counterparts, although this did not reach statistical significance.

Conclusion Results also revealed that confidence and preparation are associated with perceived outcomes. There are potentially multiple explanations (including lack of self-awareness, self-monitoring skills) for overestimations of this complex, context-bound construct that require further investigation.

Conclusion Investigating undergraduate education and training programs may find these data useful when designing academic self-monitoring and self-regulated learning initiatives and providing assistance in developing better academic self-awareness among medical students.

Thank you! Any Qs