title: A qualitative study of self-evaluation of junior doctor performance: is perceived 'safeness' a more useful metric than confidence and competence?
abstract: OBJECTIVE
  The terms confidence and competence have been poorly defined and are often misused by junior doctors. Given safe practice relies on healthcare professionals being aware of their own skill sets improving self-assessment of confidence and competence is important. The aim of this work was to explore junior doctors' understanding of how they perceive their own performance in respect of managing feverish children in an emergency department.
  
  
  METHODS
  A children's emergency department in a tertiary hospital in the East Midlands, UK.
  
  
  METHODS
  22 Junior doctors volunteered to undertake focus groups via a meta-planning methodology over 2 years (14 participants in the first year and 8 in the second).
  
  
  RESULTS
  Although doctors were aware of the difference between confidence and competence they were not able to distinguish between them in practical terms. The feeling of being 'safe' emerged as a term in which there was a shared understanding compared to reported confidence and competence.
  
  
  CONCLUSIONS
  A perception of 'safeness' is a concept that may aid self-evaluation and we present a matrix that might be used by supervisors and educators to examine this and its relationship with confidence and competence.
authors.affiliation: SAPPHIRE Group, Department of Health Sciences, University of Leicester, Leicester, UK Emergency Medicine Academic Group, University Hospitals of Leicester NHS Trust, Leicester, UK.
authors.forename: Damian
authors.initials: D
authors.lastname: Roland
authors.affiliation: Carnegie Faculty, Leeds Beckett University, Leeds, UK.
authors.forename: David
authors.initials: D
authors.lastname: Matheson
authors.affiliation: Emergency Medicine Academic Group, University Hospitals of Leicester NHS Trust, Leicester, UK.
authors.forename: Timothy
authors.initials: T
authors.lastname: Coats
authors.affiliation: SAPPHIRE Group, Department of Health Sciences, University of Leicester, Leicester, UK.
authors.forename: Graham
authors.initials: G
authors.lastname: Martin
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D059026:Diagnostic Self Evaluation; D004502:Education, Medical, Continuing; D004636:Emergency Service, Hospital; D017144:Focus Groups; D006801:Humans; D008505:Medical Staff, Hospital / Q000523:psychology*; D036301:Qualitative Research; D011795:Surveys and Questionnaires; D062606:Tertiary Care Centers; D006113:United Kingdom
keywords: GENERAL MEDICINE (see Internal Medicine); MEDICAL EDUCATION & TRAINING