Wolf E Hautz1,2, Sebastian Schubert3,4, Stefan K Schauber2,5, Olga Kunina-Habenicht6, Stefanie C Hautz1, Juliane E Kämmer3,7, Kevin W Eva8. 1. Department of Emergency Medicine, Inselspital University Hospital Bern, Bern, Switzerland. 2. Centre for Educational Measurement, Faculty of Educational Sciences, University of Oslo, Oslo, Norway. 3. AG Progresstest Medizin, Charité Universitätsmedizin Berlin, Berlin, Germany. 4. Medizinische Hochschule Brandenburg, Neuruppin, Germany. 5. Centre for Health Sciences Education, Faculty of Medicine, University of Oslo, Oslo, Norway. 6. Institute of Educational Research Methods, University of Education Karlsruhe, Karlsruhe, Germany. 7. Max Planck Institute for Human Development, Center for Adaptive Rationality (ARC), Berlin, Germany. 8. Centre for Health Education Scholarship, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Abstract
CONTEXT: The ability to self-monitor one's performance in clinical settings is a critical determinant of safe and effective practice. Various studies have shown this form of self-regulation to be more trustworthy than aggregate judgements (i.e. self-assessments) of one's capacity in a given domain. However, little is known regarding what cues inform learners' self-monitoring, which limits an informed exploration of interventions that might facilitate improvements in self-monitoring capacity. The purpose of this study is to understand the influence of characteristics of the individual (e.g. ability) and characteristics of the problem (e.g. case difficulty) on the accuracy of self-monitoring by medical students. METHODS: In a cross-sectional study, 283 medical students from 5 years of study completed a computer-based clinical reasoning exercise. Confidence ratings were collected after completing each of six cases and the accuracy of self-monitoring was considered to be a function of confidence when the eventual answer was correct relative to when the eventual answer was incorrect. The magnitude of that difference was then explored as a function of year of seniority, gender, case difficulty and overall aptitude. RESULTS: Students demonstrated accurate self-monitoring by virtue of giving higher confidence ratings (57.3%) and taking a shorter time to work through cases (25.6 seconds) when their answers were correct relative to when they were wrong (41.8% and 52.0 seconds, respectively; p< 0.001 and d > 0.5 in both instances). Self-monitoring indices were related to student seniority and case difficulty, but not to overall ability or student gender. CONCLUSIONS: This study suggests that the accuracy of self-monitoring is context specific, being heavily influenced by the struggles students experience with a particular case rather than reflecting a generic ability to know when one is right or wrong. That said, the apparent capacity to self-monitor increases developmentally because increasing experience provides a greater likelihood of success with presented problems.
CONTEXT: The ability to self-monitor one's performance in clinical settings is a critical determinant of safe and effective practice. Various studies have shown this form of self-regulation to be more trustworthy than aggregate judgements (i.e. self-assessments) of one's capacity in a given domain. However, little is known regarding what cues inform learners' self-monitoring, which limits an informed exploration of interventions that might facilitate improvements in self-monitoring capacity. The purpose of this study is to understand the influence of characteristics of the individual (e.g. ability) and characteristics of the problem (e.g. case difficulty) on the accuracy of self-monitoring by medical students. METHODS: In a cross-sectional study, 283 medical students from 5 years of study completed a computer-based clinical reasoning exercise. Confidence ratings were collected after completing each of six cases and the accuracy of self-monitoring was considered to be a function of confidence when the eventual answer was correct relative to when the eventual answer was incorrect. The magnitude of that difference was then explored as a function of year of seniority, gender, case difficulty and overall aptitude. RESULTS: Students demonstrated accurate self-monitoring by virtue of giving higher confidence ratings (57.3%) and taking a shorter time to work through cases (25.6 seconds) when their answers were correct relative to when they were wrong (41.8% and 52.0 seconds, respectively; p< 0.001 and d > 0.5 in both instances). Self-monitoring indices were related to student seniority and case difficulty, but not to overall ability or student gender. CONCLUSIONS: This study suggests that the accuracy of self-monitoring is context specific, being heavily influenced by the struggles students experience with a particular case rather than reflecting a generic ability to know when one is right or wrong. That said, the apparent capacity to self-monitor increases developmentally because increasing experience provides a greater likelihood of success with presented problems.
Authors: Jenny X Chen; Edward H Chang; Francis Deng; Shari Meyerson; Brian George; Elliott D Kozin; Stacey T Gray Journal: J Grad Med Educ Date: 2021-10-15
Authors: Martin Müller; Wolf E Hautz; Tanja Birrenbach; Michele Hoffmann; Stefanie C Hautz; Juliane E Kämmer; Aristomenis K Exadaktylos; Thomas C Sauter Journal: BMC Emerg Med Date: 2022-06-15
Authors: Stefanie C Hautz; Daniel L Oberholzer; Julia Freytag; Aristomenis Exadaktylos; Juliane E Kämmer; Thomas C Sauter; Wolf E Hautz Journal: BMC Med Educ Date: 2020-06-23 Impact factor: 2.463
Authors: Wolf E Hautz; Thomas C Sauter; Stephanie C Hautz; Juliane E Kämmer; Stefan K Schauber; Tanja Birrenbach; Aristomenis K Exadaktylos; Stephanie Stock; Martin Müller Journal: Emerg Med J Date: 2020-07-09 Impact factor: 2.740
Authors: Wolf E Hautz; Moritz M Kündig; Roger Tschanz; Tanja Birrenbach; Alexander Schuster; Thomas Bürkle; Stefanie C Hautz; Thomas C Sauter; Gert Krummrey Journal: Diagnosis (Berl) Date: 2021-10-21