Educational interventions that improve the accuracy of self-assessment in health professions: A Systematic Review (Preprint)

BACKGROUND Existing research on the accuracy of self-assessment (SA) in health professions (HP) has shown poor accuracy of SA compared to external assessors. OBJECTIVE We systematically reviewed the evidence for educational interventions aimed at improving the accuracy of SA for technical (procedural) and non-technical (critical thinking, decision making and knowledge) METHODS We conducted this systematic review according to the PRISMA guidelines using Medline, Cochrane Library, Embase, CINAHL, AMED, ERIC, Education Source, Web of Science and Scopus databases. We included studies in English that reported on educational interventions aimed at improving the accuracy of SA versus external assessment across all health professions. A narrative synthesis of the extracted data was used using a convergent integrated approach, which reported both quantitative and qualitative data. We used the modified Medical Education Research Study Quality Instrument (MMERSQI) as the critical appraisal and bias tool to evaluate the methodological quality of included studies. RESULTS After abstract and full text screening of 7439 studies, we included 35 studies and 3127 participants, the majority of which were of good methodological quality. Twenty-four studies explored SA of non-technical competencies, while 11 studies explored SA of technical competencies. Health professions included medicine (n=16), dentistry (n=9), pharmacy (n=4), nursing (n=2), physiotherapy (n=2), midwifery (n=1) and occupational therapy (n=1). The accuracy of SA was improved with the use of self-assessment rubrics (11 out of 14 studies), video review for feedback (5 out of 12 studies), verbal feedback (2 of 2 studies), electronic portfolios (2 of 2 studies), simulation (2 of 2 studies), and coaching (1 of 1 study). The use of internet-based applications (1 of 1 study) and didactic learning (1 of 1 study) did not improve the accuracy of SA. CONCLUSIONS The accuracy of self-assessment can be improved by using SA rubrics, video and verbal feedback, simulation, electronic portfolios and coaching. Limitations include a clear definition of self-assessment across research studies resulting in exclusion of systematic review. This information can be used by educators to improve the accuracy of SA within health professions education. CLINICALTRIAL PROSPERO (CRD42024586510)