Resident self-assessment of operative performance



      In medicine, the development of expertise requires the recognition of one’s capabilities and limitations. This study aimed to verify the accuracy of self-assessment for the performance of a surgical task, and to determine whether self-assessment may be improved through self-observation or exposure to relevant standards of performance.


      Twenty-six senior surgical residents were videotaped performing a laparoscopic Nissen fundoplication in a pig. Experts rated the videos using two scoring systems. Subjects evaluated their performances after performance of the Nissen, after self-observation of their videotaped performance, and after review of four videotaped “benchmark” performances.


      Expert interrater reliability was 0.66 (intraclass correlation coefficient). The correlation between experts’ and residents’ self-evaluations was initially moderate (r = 0.50, P <0.01), increasing significantly after the residents reviewed their own videotaped performance to r = 0.63 (Δr = 0.13, P <0.01), yet did not change after review of the benchmarks.


      Self-observation of videotaped performance improved the residents’ ability to self-evaluate.


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        • Spencer J.A
        • Jordan R.K
        Learner centred approaches in medical education.
        BMJ. 1999; 318: 1280-1288
        • Falchikov N
        • Boud D
        Student self-assessment in higher education.
        Rev Educ Res. 1989; 59: 395-430
        • Gordon M.J
        A review of the validity and accuracy of self-assessments in health professions training.
        Acad Med. 1991; 66: 762-769
        • Daniel S.J
        • Scruggs R.R
        • Grady J.J
        Accuracy of student self-evaluations of dental sealants.
        J Dent Hyg. 1990; 64: 339-342
        • Das M
        • Mpofu D
        • Dunn E
        • Lanphear J.H
        Self and tutor evaluations in problem-based learning tutorials.
        Med Educ. 1998; 32: 411-418
        • Fitzgerald J.T
        • Gruppen L.D
        • White C.B
        The influence of task formats on the accuracy of medical students’ self-assessments.
        Acad Med. 2000; 75: 737-741
        • Gruppen L.D
        • Garcia J
        • Grum C.M
        • et al.
        Medical students’ self-assessment accuracy in communication skills.
        Acad Med. 1997; 72: S57-59
        • Harrington J.P
        • Murnaghan J.J
        • Regehr G
        Applying a relative ranking model to the self-assessment of extended performances.
        Adv Health Sci Educ. 1997; 2: 17-25
        • Herbert W.N.P
        • McGaghie W.C
        • Droegemueller W
        • et al.
        Student evaluation in obstetrics and gynecology.
        Obstet Gynecol. 1990; 76: 458-461
        • Wooliscroft J.O
        • TenHaken J
        • Smith J
        • Calhoun J.G
        Medical students’ clinical self-assessments.
        Acad Med. 1993; 68: 285-294
        • Antonelli M.A.S
        Accuracy of second-year medical students’ self-assessment of clinical skills.
        Acad Med. 1997; 72: S63-65
        • Johnson D
        • Cujec B
        Comparison of self, nurse, and physician assessment of residents rotating through an intensive care unit.
        Crit Care Med. 1998; 26: 1811-1816
        • Risucci D.A
        • Tortolani A.J
        • Ward R.J
        Ratings of surgical residents by self, supervisors and peers.
        Surg Gynecol Obstet. 1989; 169: 519-526
        • Hays R.B
        Self-evaluation of videotaped consultations.
        Teach Learn Med. 1990; 2: 232-236
        • Palmer P.B
        • Henry J.N
        • Rohe D.A
        Effect of videotape replay on the quality and accuracy of student self-evaluation.
        Phys Ther. 1985; 65: 497-501
        • Martin D
        • Regehr G
        • Hodges B
        • McNaughton N
        Using videotaped benchmarks to improve the self-assessment ability of family practice residents.
        Acad Med. 1998; 73: 1201-1206
        • Morton J.B
        • MacBeth W.A
        Correlations between staff, peer and self assessments of fourth-year students in surgery.
        Med Educ. 1977; 11: 167-170
        • Martin J.A
        • Regehr G
        • Reznick R
        • et al.
        Objective structured assessment of technical skill (OSATS) for surgical residents.
        Br J Surg. 1997; 84: 273-278
        • Reznick R
        • Regehr G
        • MacRae H
        • et al.
        Testing technical skill via an innovative “bench station” examination.
        Am J Surg. 1996; 172: 226-230
      1. Dath D, MacRae H, Birch D, et al. Towards reliable operative assessment: the reliability and feasibility of videotaped assessment of laparoscopic technical skills. Presented at the meeting of the Association for Surgical Education, Nashville, Tennessee, April 2001

        • Calhoun J.G
        • Ten Haken J.D
        • Wooliscroft J.O
        Medical students’ development of self- and peer-assessment skills.
        Teach Learn Med. 1990; 2: 25-29
        • Sclabassi S.E
        • Woelfel S.K
        Development of self-assessment skills in medical students.
        Med Educ. 1984; 84: 226-231
        • Ward M
        • Gruppen L
        • Regehr G
        Measuring self-assessment.
        Adv Health Sci Educ. 2000; 7: 63-80