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While the accreditation standards of most health-related disciplines emphasize the importance of selfawareness and accurate self-assessment, decades of social psychological research suggests that these standards will be difficult to attain. Indeed, a host of sub-conscious cognitive processes conspire to ensure that self-assessments are unjustifiably charitable. The review describes said cognitive processes, discusses the most common manifestations of biased self-assessment, and offers guidance on interventions. The review's overarching theme; however, is that because self-enhancement is so deeply engrained, it will be impossible to eradicate at a global level. The most effective interventions may be those that help students to function in spite of imperfect self-knowledge.Keywords: self, self-awareness, self-assessment, self-knowledge, bias, psychology Unbiased self-knowledge seems critical for professionals who routinely make life and health altering decisions.1-5 Indeed, Standard 4.1 of the Standards 2016 and Domain 4 of CAPE addresses it directly: The graduate is able to examine and reflect on personal, knowledge, skills, abilities, beliefs, biases, motivation, and emotions that could enhance or limit personal growth. Several lines of research in clinical education, however, suggest that both students' and clinicians' self-knowledge is often biased. 6-14The goal of this manuscript is to demonstrate that completely unbiased self-knowledge is neither attainable nor desirable, because bias is deeply engrained, and because the mechanisms that cause bias occur below awareness. 15 Consequently, the manuscript also argues that interventions that help students Consequences of Biased Self-AssessmentBefore entertaining solutions to a problem, one should assess its extent; hence, the manuscript reviews common situations in with peoples' estimates of their character, abilities, or future prospects are more optimistic than reality warrants. The manifestations include, the better than average effect, low correlations between ability estimates and actual performance, and One of the most common manifestations of biased self-knowledge is low correlations between ability estimates and actual performance. For example, only seven out of twenty papers in a meta-analysis of practicing physicians' self-assessment accuracy reported a moderate positive correlation between physicians' self-assessment and their performance; the remaining papers reported either non-significant or negative correlations. Like knowledge of one's abilities, knowledge of one's traits is imperfect. 21 The Big Five personality inventory-an instrument that classifies respondents in terms of openness, conscientiousness, extraversion, agreeableness, and neuroticism-only correlates with related behaviors at 0.34 when the behaviors are performed in a lab 22 and 0.27 when the behaviors are performed outside of a lab. 23 In one of the most thorough investigations of the relationship between self-reports and behavior, researchers asked participants to wear an...

The current research investigates whether implicit-explicit attitudinal discrepancy (IED) weakens attitudes as explicit discrepancies do. Across two experiments, we found that IED is an indicator of weak attitudes. In Experiment 1, we found that individuals with greater IED toward exercise were more swayed by a self-perceptual manipulation than individuals with lower IED toward exercise. In Experiment 2, we found that the stability and predictive power of attitudes toward alcohol were lessened for participants who had greater IED. These effects occurred independently of the participants' levels of explicit ambivalence and evaluative-cognitive consistency. The present research broadens our understanding of the ways in which evaluations that may not be easily verbalized can affect our thoughts and behavior.

In an appeal to establish transformative learning’s (TL) boundaries, Kegan (2000) implored researchers to identify “what from transforms?” As a social psychologist, I am particularly drawn to theorists who identify the self as the form that transforms; however, I argue that a model of the self that specifies how it is represented in memory offers advantages to the prevailing models of the self-advanced by transformative learning theorists. Since a multiple self-framework specifies how the self is represented in memory, it is more specific than previous models and it is amenable to research methods beyond retrospective reports. Additionally, it offers several explanations of how transformation may occur and provides an alternative explanation for incomplete transformations. In doing so, it adds to theories attempting to identify the form that transforms.

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