title: Self-assessment or self deception? A lack of association between nursing students' self-assessment and performance.
abstract: OBJECTIVE
  The aim of this study was to examine senior year nursing students' ability to self-assess their performance when responding to simulated emergency situations.
  
  
  BACKGROUND
  Self-assessment is viewed as a critical skill in nursing and other health professional programmes. However, while students may spend considerable time completing self-assessments, there is little evidence that they actually acquire the skills to do so effectively. By contrast, a number of studies in medicine and elsewhere have cast doubt on the validity of self-assessment.
  
  
  METHODS
  In 2007, a one-group pre-test, post-test design was used to answer the question, 'How accurate are senior year nursing students in assessing their ability to respond to emergency situations in a simulated medical/surgical environment compared to observer assessment of their performance?' A total of 27 fourth year nursing students from a university in Ontario were asked to complete a questionnaire before and after an objective structured clinical examination which assessed their ability to respond to emergency situations. Self-assessments were compared with observed performance.
  
  
  RESULTS
  The experience of dealing with the simulated crisis situations significantly increased perceived confidence and perceived competence in dealing with emergency situations, although it did not affect self-perceived ability to communicate or collaborate. All but 1 of the 16 correlations between self-assessment and the objective structured clinical examination total scores were negative. Their self-assessment was also unrelated to several indices of experience in critical care settings.
  
  
  CONCLUSIONS
  Self-assessment in nursing education to evaluate clinical competence and confidence requires serious reconsideration as our well-intentioned emphasis on this commonly used practice may be less than effective.
authors.affiliation: School of Nursing, Faculty of Health Sciences McMaster University, Hamilton, Ontario, Canada. baxterp@mcmaster.ca
authors.forename: Pamela
authors.initials: P
authors.lastname: Baxter
authors.forename: Geoff
authors.initials: G
authors.lastname: Norman
mesh_terms: D000328:Adult; D002983:Clinical Competence; D008192:Deception; D004506:Education, Nursing / Q000379:methods*; D004521:Educational Measurement / Q000592:standards*; D004630:Emergencies / Q000451:nursing; D005260:Female; D006801:Humans; D015402:Nursing Education Research; D009864:Ontario; D016032:Randomized Controlled Trials as Topic; D012647:Self-Assessment; D013338:Students, Nursing / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult