title: Applying a relative ranking model to the self-assessment of extended performances.
abstract: BACKGROUND
  Accurate self-assessment is an important but underdeveloped skill in medicine that, in the past, has received little formal attention from educators.
  
  
  METHODS
  Following an orthopedic rotation, twenty-five orthopedic surgery residents performed a self-assessment task for ten skills using a new relative ranking method, in which an individual's skills are ranked relative to each other rather than being compared to the individual's peers. Supervising faculty assessed residents using the same instrument. Faculty inter-rater reliability was measured and comparisons were made between each resident's self-assessment and the faculty assessments using Spearman rank order correlation coefficients.
  
  
  RESULTS
  The mean correlation between faculty rating the same resident was 0.27 (sd = 0.49). The mean correlation between resident and faculty rankings was 0.20 (sd = 0.38), but was higher for junior residents (0.33) than for senior residents (0.12), apparently because senior residents do not alter their self-assessments while faculty change their assessments of senior residents.
  
  
  CONCLUSIONS
  Consistent with the literature in other fields, we find that self-assessment is poor among surgical trainees when they are asked to assess their own performance over an extended time period.
authors.affiliation: Faculty of Medicine Centre for Research in Education and Department of Surgery, University of Toronto, Eaton 8-323, 200 Elizabeth Street, Toronto, Ontario, Canada M5G 2C4.
authors.forename: J P
authors.initials: JP
authors.lastname: Harrington
authors.forename: J J
authors.initials: JJ
authors.lastname: Murnaghan
authors.forename: G
authors.initials: G
authors.lastname: Regehr