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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Tensions in informed self-assessment: How the desire for feedback and reticence to collect and use it can conflict
Academic Medicine, Volume 86, No. 9, Year 2011
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Description
Purpose: Informed self-assessment describes the set of processes through which individuals use external and internal data to generate an appraisal of their own abilities. The purpose of this project was to explore the tensions described by learners and professionals when informing their self-assessments of clinical performance. Method: This 2008 qualitative study was guided by principles of grounded theory. Eight programs in five countries across undergraduate, postgraduate, and continuing medical education were purposively sampled. Seventeen focus groups were held (134 participants). Detailed analyses were conducted iteratively to understand themes and relationships. Results: Participants experienced multiple tensions in informed self-assessment. Three categories of tensions emerged: within people (e.g., wanting feedback, yet fearing disconfirming feedback), between people (e.g., providing genuine feedback yet wanting to preserve relationships), and in the learning/practice environment (e.g., engaging in authentic self-assessment activities versus "playing the evaluation game"). Tensions were ongoing, contextual, and dynamic; they prevailed across participant groups, infusing all components of informed self-assessment. They also were present in varied contexts and at all levels of learners and practicing physicians. Conclusions: Multiple tensions, requiring ongoing negotiation and renegotiation, are inherent in informed self-assessment. Tensions are both intraindividual and interindividual and they are culturally situated, reflecting both professional and institutional influences. Social learning theories (social cognitive theory) and sociocultural theories of learning (situated learning and communities of practice) may inform our understanding and interpretation of the study findings. The findings suggest that educational interventions should be directed at individual, collective, and institutional cultural levels. Implications for practice are presented. © 2011 Association of American Medical Colleges.
Authors & Co-Authors
Mann, Karen
Canada, Halifax
Dalhousie University, Faculty of Medicine
United Kingdom, Manchester
The University of Manchester
Van Der Vleuten, Cees P.M.
Netherlands, Maastricht
Universiteit Maastricht
Saudi Arabia, Riyadh
King Saud University
Denmark, Copenhagen
Københavns Universitet
Eva, K.
Canada, Vancouver
The University of British Columbia
Armson, Heather
Canada, Calgary
Cumming School of Medicine
Canada, Hamilton
Mcmaster University
Chesluk, Benjamin J.
United States, Philadelphia
American Board of Internal Medicine
Tim Dornan, Tim L.
United Kingdom, Manchester
The University of Manchester
Netherlands, Maastricht
Universiteit Maastricht
Holmboe, Eric
United States, Philadelphia
American Board of Internal Medicine
Lockyer, Jocelyn Margot
Canada, Calgary
University of Calgary
Loney, Elaine
Unknown Affiliation
Sargeant, Joan M.
Canada, Halifax
Dalhousie University, Faculty of Medicine
Statistics
Citations: 180
Authors: 10
Affiliations: 10
Identifiers
Doi:
10.1097/ACM.0b013e318226abdd
ISSN:
10402446
Study Design
Grounded Theory
Study Approach
Qualitative