title: The effect of in-training assessment on clinical confidence in postgraduate education.
abstract: BACKGROUND
  The literature on how in-training assessment (ITA) works in practice and what educational outcomes can actually be achieved is limited. One of the aims of introducing ITA is to increase trainees' clinical confidence; this relies on the assumption that assessment drives learning through its content, format and programming. The aim of this study was to investigate the effect of introducing a structured ITA programme on junior doctors' clinical confidence. The programme was aimed at first year trainees in anaesthesiology.
  
  
  METHODS
  The study involved a nationwide survey of junior doctors' self-confidence in clinical performance before (in 2001) and 2 years after (in 2003) the introduction of an ITA programme. Respondents indicated confidence on a 155-item questionnaire related to performance of clinical skills and tasks reflecting broad aspects of competence. A total of 23 of these items related to the ITA programme.
  
  
  RESULTS
  The response rate was 377/531 (71%) in 2001 and 344/521 (66%) in 2003. There were no statistically significant differences in mean levels of confidence before and 2 years after the introduction of the ITA programme - neither in aspects that were related to the programme nor in those that were unrelated to the programme.
  
  
  CONCLUSIONS
  This study demonstrates that the introduction of a structured ITA programme did not have any significant effect on trainees' mean level of confidence on a broad range of aspects of clinical competence. The importance of timeliness and rigorousness in the application of ITA is discussed.
authors.affiliation: Copenhagen Hospital Corporation Postgraduate Medical Institute, Bispebjerg Hospital, Copenhagen, Denmark. charlotte.ringsted@rh.dk
authors.forename: Charlotte
authors.initials: C
authors.lastname: Ringsted
authors.forename: Jane
authors.initials: J
authors.lastname: Pallisgaard
authors.forename: Doris
authors.initials: D
authors.lastname: Østergaard
authors.forename: Albert
authors.initials: A
authors.lastname: Scherpbier
mesh_terms: D000776:Anesthesiology / Q000193:education; D002983:Clinical Competence / Q000592:standards*; D003718:Denmark; D004503:Education, Medical, Graduate / Q000379:methods*; D004521:Educational Measurement / Q000592:standards; D005260:Female; D006801:Humans; D007318:Inservice Training / Q000592:standards; D007396:Internship and Residency; D008297:Male