How does multisource feedback influence residency training? A qualitative case study

Development of an instrument for medical students' self-assessment of facets of competence for patient-centred care

OBJECTIVE

To develop a facets of competence self-assessment instrument (FOCSI) with operationalised items for ten competence facets required for patient-centred care at the beginning of residency.

METHODS

We conducted focus groups and cognitive interviews with final-year medical students to develop items that match students' clinical experience. We tested 50 items in two samples and analysed model fit and internal consistency of all possible combinations to identify the optimal ten-item-solution. Item analysis was performed as well as correlation with six personality traits.

RESULTS

An optimal ten-item solution for the self-assessment instrument emerged for sample 1 (n = 101, 27.2 ± 3.5 years, 75.2 % female). We validated the model fit with sample 2 (n = 135, 27.7 ± 3.9 years, 66.7 % female): χ2(35) = 49.3, p = .055, CFI = .94, RMSEA = .055, SRMR = .058, Cronbach's alpha = .78. The personality factors 'Conscientiousness' and 'Extraversion' correlate positively with most FOCSI items.

CONCLUSION

The operationalised FOCSI items support undergraduate medical students close to graduation in realistic self-assessment of facets of competences for patient-centred care in their transition to residency.

PRACTICE IMPLICATIONS

Realistic self-assessment of facets of competence will provide medical students with the opportunity to monitor their competence development as part of self-directed learning for gaining adaptive expertise in professional, patient-centred care.