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Abstract：
BACKGROUND: Core physician activities of lifelong learning, continuing medical education credit, relicensure, specialty recertification, and clinical competence are linked to the abilities of physicians to assess their own learning needs and choose educational activities that meet these needs.
OBJECTIVE: To determine how accurately physicians self-assess compared with external observations of their competence.
METHODS: The electronic databases MEDLINE (1966-July 2006), EMBASE (1980-July 2006), CINAHL (1982-July 2006), PsycINFO (1967-July 2006), the Research and Development Resource Base in CME (1978-July 2006), and proprietary search engines were searched using terms related to self-directed learning, self-assessment, and self-reflection.
METHODS: Studies were included if they compared physicians\' self-rated assessments with external observations, used quantifiable and replicable measures, included a study population of at least 50% practicing physicians, residents, or similar health professionals, and were conducted in the United Kingdom, Canada, United States, Australia, or New Zealand. Studies were excluded if they were comparisons of self-reports, studies of medical students, assessed physician beliefs about patient status, described the development of self-assessment measures, or were self-assessment programs of specialty societies. Studies conducted in the context of an educational or quality improvement intervention were included only if comparative data were obtained before the intervention.
METHODS: Study population, content area and self-assessment domain of the study, methods used to measure the self-assessment of study participants and those used to measure their competence or performance, existence and use of statistical tests, study outcomes, and explanatory comparative data were extracted.
RESULTS: The search yielded 725 articles, of which 17 met all inclusion criteria. The studies included a wide range of domains, comparisons, measures, and methodological rigor. Of the 20 comparisons between self- and external assessment, 13 demonstrated little, no, or an inverse relationship and 7 demonstrated positive associations. A number of studies found the worst accuracy in self-assessment among physicians who were the least skilled and those who were the most confident. These results are consistent with those found in other professions.
CONCLUSIONS: While suboptimal in quality, the preponderance of evidence suggests that physicians have a limited ability to accurately self-assess. The processes currently used to undertake professional development and evaluate competence may need to focus more on external assessment.
OBJECTIVE: To determine how accurately physicians self-assess compared with external observations of their competence.
METHODS: The electronic databases MEDLINE (1966-July 2006), EMBASE (1980-July 2006), CINAHL (1982-July 2006), PsycINFO (1967-July 2006), the Research and Development Resource Base in CME (1978-July 2006), and proprietary search engines were searched using terms related to self-directed learning, self-assessment, and self-reflection.
METHODS: Studies were included if they compared physicians\' self-rated assessments with external observations, used quantifiable and replicable measures, included a study population of at least 50% practicing physicians, residents, or similar health professionals, and were conducted in the United Kingdom, Canada, United States, Australia, or New Zealand. Studies were excluded if they were comparisons of self-reports, studies of medical students, assessed physician beliefs about patient status, described the development of self-assessment measures, or were self-assessment programs of specialty societies. Studies conducted in the context of an educational or quality improvement intervention were included only if comparative data were obtained before the intervention.
METHODS: Study population, content area and self-assessment domain of the study, methods used to measure the self-assessment of study participants and those used to measure their competence or performance, existence and use of statistical tests, study outcomes, and explanatory comparative data were extracted.
RESULTS: The search yielded 725 articles, of which 17 met all inclusion criteria. The studies included a wide range of domains, comparisons, measures, and methodological rigor. Of the 20 comparisons between self- and external assessment, 13 demonstrated little, no, or an inverse relationship and 7 demonstrated positive associations. A number of studies found the worst accuracy in self-assessment among physicians who were the least skilled and those who were the most confident. These results are consistent with those found in other professions.
CONCLUSIONS: While suboptimal in quality, the preponderance of evidence suggests that physicians have a limited ability to accurately self-assess. The processes currently used to undertake professional development and evaluate competence may need to focus more on external assessment.
摘要：
背景：终身学习的核心医师活动，继续医学教育学分，重新保证，专业重新认证，和临床能力与医生评估自己的学习需求并选择满足这些需求的教育活动的能力有关。
目的：确定医生自我评估与外部观察相比的准确性。
方法：电子数据库MEDLINE（1966-2006年7月），EMBASE(1980-2006年7月),CINAHL（1982年-2006年7月），PsycINFO（1967年-2006年7月），CME研发资源库(1978-2006年7月)，专有搜索引擎使用与自主学习相关的术语进行搜索，自我评估,和自我反省。
方法：如果将医生的自我评估与外部观察进行比较，则纳入研究。使用可量化和可复制的措施，包括至少50%执业医生的研究人群，居民,或类似的卫生专业人员，并在英国进行，加拿大,美国,澳大利亚,或新西兰。如果是自我报告的比较，研究被排除在外，医学生的研究，评估医生对患者状态的信念，描述了自我评估措施的发展，或者是专业社团的自我评估计划。只有在干预前获得比较数据的情况下，才包括在教育或质量改善干预的背景下进行的研究。
方法：研究人群，研究的内容领域和自我评估领域，用于衡量研究参与者的自我评估以及用于衡量其能力或绩效的方法，统计检验的存在和使用，研究结果，并提取了解释性比较数据。
结果：搜索产生了725篇文章，其中17人符合所有纳入标准。这些研究包括广泛的领域，比较,措施，和方法上的严谨。在自我评估和外部评估之间的20个比较中，13显示很少，不,或反比关系，7个表现出正相关。许多研究发现，在最不熟练和最自信的医生中，自我评估的准确性最差。这些结果与其他行业的结果一致。
结论：虽然质量欠佳，大量证据表明,医生准确自我评估的能力有限.目前用于进行专业发展和评估能力的过程可能需要更多地关注外部评估。
目的：确定医生自我评估与外部观察相比的准确性。
方法：电子数据库MEDLINE（1966-2006年7月），EMBASE(1980-2006年7月),CINAHL（1982年-2006年7月），PsycINFO（1967年-2006年7月），CME研发资源库(1978-2006年7月)，专有搜索引擎使用与自主学习相关的术语进行搜索，自我评估,和自我反省。
方法：如果将医生的自我评估与外部观察进行比较，则纳入研究。使用可量化和可复制的措施，包括至少50%执业医生的研究人群，居民,或类似的卫生专业人员，并在英国进行，加拿大,美国,澳大利亚,或新西兰。如果是自我报告的比较，研究被排除在外，医学生的研究，评估医生对患者状态的信念，描述了自我评估措施的发展，或者是专业社团的自我评估计划。只有在干预前获得比较数据的情况下，才包括在教育或质量改善干预的背景下进行的研究。
方法：研究人群，研究的内容领域和自我评估领域，用于衡量研究参与者的自我评估以及用于衡量其能力或绩效的方法，统计检验的存在和使用，研究结果，并提取了解释性比较数据。
结果：搜索产生了725篇文章，其中17人符合所有纳入标准。这些研究包括广泛的领域，比较,措施，和方法上的严谨。在自我评估和外部评估之间的20个比较中，13显示很少，不,或反比关系，7个表现出正相关。许多研究发现，在最不熟练和最自信的医生中，自我评估的准确性最差。这些结果与其他行业的结果一致。
结论：虽然质量欠佳，大量证据表明,医生准确自我评估的能力有限.目前用于进行专业发展和评估能力的过程可能需要更多地关注外部评估。
