Examining student self-awareness of performance on entrustable professional activities given context of preceptor evaluations

IntroductionIn experiential learning, student self-evaluation is used to determine students' self-awareness. At our institution, we ask students to self-assess their performance on Entrustable Professional Activities (EPAs) on Direct Patient Care rotations. ObjectivesThe purpose of this study is to investigate if students can accurately self-evaluate performance on EPAs during patient care practice experiences and if their accuracy and therefore, self-awareness, improves over time. MethodsThis is a retrospective study using data that was collected from both student and preceptor final evaluations at three time points: T1 or Direct Patient Care Introductory Pharmacy Practice Experience (IPPE) (second or third year), T2 or the First Direct Patient Care Advanced Pharmacy Practice Experience (APPE) (fourth year), and T3 or the Last Direct Patient Care APPE (fourth year). The primary end point examined change in accuracy over time across all EPAs (global accuracy). The secondary end point examined bias or the under-/overconfidence. The tertiary end point examined if student accuracy for individual EPAs changes over time. ResultsFor the primary end point, global accuracy, accuracy significantly improved over time (P < .001) with time point one (T1 = 0.52) being more inaccurate than time point two (T2 = 0.26) and time point three (T3 = 0.027). For the secondary end point, bias (degree of under-/overconfidence), there was no significant difference over time. When examining each individual EPA for changes in accuracy over time, we found individual EPAs showed the same significant trend (P < .001) as global scores. ConclusionStudents' self-assessment accuracy and therefore self-awareness of their performance on EPAs improves over time. In all EPAs, the significant improvement in accuracy occurs between the students' Direct Patient Care IPPE (T1) and their first Patient Care APPE (T2). This evidence suggests the importance of early exposure of students to direct patient care activities, and that self-evaluation of EPAs is beneficial to student development and leads to improved self-awareness of their performance over time.