Final-year medical students’ self-assessment of facets of competence for beginning residents

Abstract

Background Final-year undergraduate medical students often do not feel well prepared for their start of residency training. Self-assessment of competences is important so that medical trainees can take responsibility for their learning. In this study, we investigated how final-year medical students self-assessed their competences as they neared their transition to postgraduate training. The aim was to identify areas for improvement in undergraduate training. Methods In the academic year 2019/2020, a national online survey was sent to final-year undergraduate medical students via their respective medical schools. The survey included ten facets of competence (FOC) most relevant for beginning residents. The participants were asked to self-assess their competence for each FOC on a 5-point Likert scale (1: strongly disagree to 5: strongly agree). We established an order of self-assessed FOC performance by means and calculated paired t-tests. Gender differences were assessed with independent t-tests. Results A total of 1083 students from 35 medical schools completed the questionnaire. Mean age was 27.2 ± 3.1 years and 65.8% were female. Students rated their performance highest in the FOCs ‘Teamwork and collegiality’ and ‘Empathy and openness’ (97.1 and 95.0% ‘strongly agree’ or ‘agree’, respectively) and lowest in ‘Verbal communication with colleagues and supervisors’ and ‘Scientifically and empirically grounded method of working’ (22.8 and 40.2% ‘strongly disagree’, ‘disagree’, or ‘neither agree nor disagree’, respectively). Women rated their performance of ‘Teamwork and collegiality’, ‘Empathy and openness’, and ‘Knowing and maintaining own personal bounds and possibilities’ significantly higher than men did (Cohen’s d > .2), while men showed higher self-assessed performance in ‘Scientifically and empirically grounded method of working’ than women (Cohen’s d = .38). The FOCs ‘Responsibility’, ‘Knowing and maintaining own personal bounds and possibilities’, ‘Structure, work planning, and priorities’, ‘Coping with mistakes’, and ‘Scientifically and empirically grounded method of working’ revealed lower self-assessed performance than the order of FOC relevance established by physicians for beginning residents. Conclusions The differences between the level of students’ self-assessed FOC performance and physicians’ ranking of FOC relevance revealed areas for improvement in undergraduate medical education related to health system sciences. Final-year students might benefit from additional or better training in management skills, professionalism, and evidence-based medicine. Surveys of self-assessed competences may be useful to monitor competence development during undergraduate training.

Assessment of final-year medical students’ entrustable professional activities after education on an interprofessional training ward: A case-control study

“…This competency was ranked highly when physician educators were asked to assess the relevance of different competencies for beginning residents [12]. When final-year medical students in Germany were asked to self-assess their competency with respect to ten competencies relevant for beginning residents, they rated their competence level for this facet on average the second lowest [33]. We assume that the students in our study, who were placed on the ITW, gained a lot of experience in verbal communication with colleagues and supervisors because presentation of their patients to the team was an explicit part of their daily work routine on the ITW and could have led to higher entrustment levels in the above-mentioned EPAs.…”

“…Better EPA scores in the ITW group could be related to the competency 'Structure, work planning and priorities'. Its performance level is rated as one of the lowest in final-year students' self-assessment [33], while it is regarded to be highly important for residency by physicians [13] and medical students [35]. Students on our ITW are constantly in the position to prioritize and structure their work according to the demands of the patients' situation.…”

Do educational interventions reduce the gender gap in communication skills?- A systematic review

“…Regardless of the methods of assessment, both self-reported and observed communication skills and their components, such as empathy, patient-centered care, perspective-taking, and verbal and non-verbal communication skills show that male medical students score signi cantly lower than female medical students [5][6][7][8][9][10][11]. The differences persist after medical education and female physicians in general tend to be more patient-centered, and have more positive attitudes toward patient-centeredness, communication skills, and empathy than males [12].…”

“…BACKGROUND E cient doctor-patient communication is essential for improving patients' satisfaction, compliance with treatment and outcomes[1, 2] Good communication skills have bene ts for physicians, such as increase in job-satisfaction, well-being, and burnout prevention [3]. Despite the undisputed importance of communication skills, there is a well-documented gender gap between female and male physicians [4].Regardless of the methods of assessment, both self-reported and observed communication skills and their components, such as empathy, patient-centered care, perspective-taking, and verbal and non-verbal communication skills show that male medical students score signi cantly lower than female medical students [5][6][7][8][9][10][11]. The differences persist after medical education and female physicians in general tend to be more patient-centered, and have more positive attitudes toward patient-centeredness, communication skills, and empathy than males [12].…”

Virtual Reality for Assessing Emergency Medical Competencies in Junior Doctors – A Pilot Study

“…Additionally, assessment of EMC using the VR simulation was automatically conducted using the STEP-VR program, which recorded all relevant actions performed by the user in a scenario-speci c checklist. The checklists for each scenario had been previously established by the authors based on guidelines from professional societies [20][21][22]. All checklist items are listed in Table 4.…”