title: Are General Surgery Residents Accurate Assessors of Their Own Flexible Endoscopy Skills?
abstract: BACKGROUND
  Surgeons in training must be able to accurately gauge their own ability and performance to better understand where additional practice is needed and can help inform self-directed learning endeavors. This study had the following 3 goals: (1) to examine the accuracy of residents' assessments of their endoscopic skills, (2) to investigate if accuracy improves over time and practice, and (3) to compare the efficacy of 3 interventions-practice only (PO), self-observation (SO), or expert observation (EO)-on self-assessment accuracy.
  
  
  METHODS
  Overall, 30 first-year general surgery residents completed a pretest on a colonoscopy simulator, which measured time to completion, time to reach the cecum, efficiency of screening, percentage of mucosal surface area examined, time the patient was in pain, and time with a clear view. Residents assigned to the SO and EO conditions reviewed a video of their own performances (SO) or an expert's performance (EO). Residents in all conditions engaged in practice trials using an abstract endoscopy training exercise. Residents then completed a posttest. Self-assessment was examined by calculating discrepancy scores by subtracting actual measurements from participant judgments.
  
  
  RESULTS
  Results indicated that performance for participants in the PO group significantly improved from pretest to posttest for 2 of the 6 metrics and participants in the SO and EO groups improved for 4 metrics. In terms of self-assessment discrepancy scores, only the EO group significantly improved for 2 of the 6 metrics (overall time and screening efficiency).
  
  
  CONCLUSIONS
  Novice trainees are inaccurate self-assessors of their endoscopic skills before training. Allowing trainees to watch videos of themselves or an expert performing an endoscopic task enhances performance. Participants assigned to PO exhibited decreased ability to accurately judge their own performance. Those in the EO group became significantly better at assessing their overall time and overall efficiency.
  
  
  CONCLUSIONS
  Novice trainees are inaccurate self-assessors of their endoscopic skills before training. Allowing trainees to watch videos of themselves or an expert performing an endoscopic task enhances performance.
authors: Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas.
authors: Parth
authors: P
authors: Vyasa
authors: Department of Surgery, University of Texas Health Sciences Center San Antonio, San Antonio, Texas.
authors: Ross E
authors: RE
authors: Willis
authors: Department of Surgery, Houston Methodist Hospital, Houston, Texas.
authors: Brian J
authors: BJ
authors: Dunkin
authors: Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas. Electronic address: aimee.gardner@utsouthwestern.edu.
authors: Aimee K
authors: AK
authors: Gardner
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003479:Curriculum; D004503:Education, Medical, Graduate / Q000379:methods; D004521:Educational Measurement; D004724:Endoscopy / Q000193:education*; D005260:Female; D005336:Fiber Optic Technology; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration*; D008297:Male; D015397:Program Evaluation; D000066908:Simulation Training / Q000379:methods; D014481:United States
keywords: Patient Care; Practice-Based Learning and Improvement; Systems-Based Practice; education; endoscopy; residents; self-assessment; video review