title: "Directed" self-assessment: practice and feedback within a social context.
abstract: BACKGROUND
  Accurate self-assessment appears to be difficult and, some would propose, even impossible. Recent reviews suggest that peer assessment may be more accurate and that multisource feedback (MSF) may inform self-assessment. We had conducted a series of studies of family physicians in an MSF program including assessments from patients, medical colleagues, and coworkers and self-assessment. Using this body of research, this article explores self-assessment within the social context of multisource feedback and investigates the influence of feedback from peers and others upon self-assessment.
  
  
  METHODS
  This is a review article in which we synthesized findings of the series of studies with respect to self-assessment, used conclusions to propose a model for self-assessment within a social context, and suggest practical and research implications.
  
  
  RESULTS
  Physicians compared peers' and others' assessment feedback with global self-perceptions of performance. Negative feedback, especially from medical colleagues, that was inconsistent with self-perceptions was not readily reconciled with self-assessments. Multiple internal and environmental factors influenced reconciliation and assimilation of negative feedback. Reflection upon feedback and self-perceptions appeared to be instrumental to reconciliation, and reflection could be facilitated.
  
  
  CONCLUSIONS
  We propose a model of "directed" self-assessment to facilitate the integration of external feedback, especially negative feedback, with self-perceptions and enable its use for practice improvement. Implications for education and research include increasing understanding of ways physicians assimilate external feedback and of the role of educators as facilitators of "directed" self-assessment and self-learning to assist physicians in integrating external feedback.
authors: Office of Continuing Medical Education, Dalhousie University Faculty of Medicine, Dalhousie University, Halifax, Canada. joan.sargeant@dal.ca
authors: Joan
authors: J
authors: Sargeant
authors: Karen
authors: K
authors: Mann
authors: Cees
authors: C
authors: van der Vleuten
authors: Job
authors: J
authors: Metsemakers
mesh_terms: D002983:Clinical Competence; D004502:Education, Medical, Continuing / Q000379:methods*; D030141:Feedback, Psychological; D006801:Humans; D007858:Learning; D017145:Models, Educational; D018024:Peer Review, Health Care; D012647:Self-Assessment; D012655:Self-Evaluation Programs / Q000379:methods*