title: How do gender and anxiety affect students' self-assessment and actual performance on a high-stakes clinical skills examination?
abstract: OBJECTIVE
  Research suggests that medical students are not accurate in self-assessment, but it is not clear whether students over- or underestimate their skills or how certain characteristics correlate with accuracy in self-assessment. The goal of this study was to determine the effect of gender and anxiety on accuracy of students' self-assessment and on actual performance in the context of a high-stakes assessment.
  
  
  METHODS
  Prior to their fourth year of medical school, two classes of medical students at Johns Hopkins University School of Medicine completed a required clinical skills exam in fall 2010 and 2011, respectively. Two hundred two students rated their anxiety in anticipation of the exam and predicted their overall scores in the history taking and physical examination performance domains. A self-assessment deviation score was calculated by subtracting each student's predicted score from his or her score as rated by standardized patients.
  
  
  RESULTS
  When students self-assessed their data gathering performance, there was a weak negative correlation between their predicted scores and their actual scores on the examination. Additionally, there was an interaction effect of anxiety and gender on both self-assessment deviation scores and actual performance. Specifically, females with high anxiety were more accurate in self-assessment and achieved higher actual scores compared with males with high anxiety. No differences by gender emerged for students with moderate or low anxiety.
  
  
  CONCLUSIONS
  Educators should take into account not only gender but also the role of emotion, in this case anxiety, when planning interventions to help improve accuracy of students' self-assessment.
authors.affiliation: Office of Assessment and Evaluation, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA jcolber2@jhmi.edu
authors.forename: Jorie M
authors.initials: JM
authors.lastname: Colbert-Getz
authors.forename: Carol
authors.initials: C
authors.lastname: Fleishman
authors.forename: Julianna
authors.initials: J
authors.lastname: Jung
authors.forename: Nicole
authors.initials: N
authors.lastname: Shilkofski
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001007:Anxiety / Q000523:psychology*; D002983:Clinical Competence; D004504:Education, Medical, Undergraduate; D004521:Educational Measurement; D005260:Female; D006801:Humans; D008297:Male; D016544:Patient Simulation; D012647:Self-Assessment; D012655:Self-Evaluation Programs; D012737:Sex Factors; D013337:Students, Medical / Q000523:psychology*