I just don't know what I'm supposed to know: Evaluating self-assessment skills of international pharmacy graduates in Canada

Background: Self-assessment skills are an integral part of pharmacy education and practice, yet there is very little empirical evidence in health professions to indicate that students and practitioners possess adequate and appropriate self-assessment skills. Objectives: To evaluate self-assessment skills of international pharmacy graduates (pharmacists from outside Canada or the United States seeking licensure in Canada). Methods: An 8-station objective structured clinical examination was used. Within each station, 2 trained and experienced pharmacist raters completed analytical and global assessments of participants. After each station, participants themselves completed the same assessments, as well as providing additional anecdotal feedback regarding their performance. In stations possessing sufficient interrater reliability, comparisons were made between raters' assessments and self-assessments. Results: Across all performance quartiles there was a discrepancy between self-assessments and rater assessments of clinical performance. The discrepancy was largest in the lowest quartiles, suggesting impairment of self-assessment may be greatest amongst those who have the weakest skills. Conclusions: Not all individuals possess adequate and appropriate self-assessment skills. Further work is required to elucidate the link between clinical competence and self-assessment and to determine methods for improving self-assessment skills. (C) 2008 Elsevier Inc. All rights reserved.