Pharmacy Resident
University of Maryland Medical Center
Lifelong learning is widely accepted as an essential component of a career in healthcare. Pharmacists must keep up with the dozens of new drugs approved in the United States annually, not to mention approvals of established drugs for new indications, guideline updates, and primary literature. Pharmacy students receive constant feedback to guide their learning as they progress through both didactic and experiential components of their curricula. After graduation, however, this feedback may become less frequent as supervision becomes less direct, requiring pharmacists to gauge their own performance and guide their own learning accordingly. Incorporating self-assessment into pharmacy curricula may help future pharmacists learn to identify gaps in their own knowledge in preparation for this transition.
In 2022, a research team at Monash University in Australia conducted a study to characterize the self-assessment skills of 162 third-year pharmacy students. Students developed action plans for an oncology case, reviewed an expert response to the case, then used a rubric to assess their own action plans two days later. The following month, students completed an end-of-course assessment containing a similar case for which they were asked to develop an action plan. Course examiners reviewed and scored the initial action plans, as well as the action plans developed for the end-of-course assessment.1
Based on previous literature, this group hypothesized that students would have a “low to moderate ability to self-assess, with low-performing students being more likely to overestimate their performance.” When students were divided into tertiles based on their scores on the action plan, it was found that middle and higher tertiles underestimated their own performance, on average, with more significant underestimation observed in the higher tertile. Students in the lower tertile, on average, overestimated their performance. There was a weak, positive correlation observed between academic performance on the action plan and self-assessment accuracy, but no correlation between performance on the end-of-course assessment question and self-assessment accuracy. Additionally, there was no difference observed between student scores on the initial action plan and the end-of-course assessment action plan, implying that the self-assessment exercise did not lead to an improvement in performance.1
A limitation discussed by the authors was that students likely do not have a clear understanding of the value of self-assessment, which may have impacted the way they completed these assessments.1 Additionally, knowing that they will receive expert feedback may lower students’ motivation to conduct a thoughtful self-assessment. The fact that self-assessments are submitted to faculty may also impact how they evaluate themselves; for instance, grading themselves lower to avoid appearing overconfident.
In their 2010 review, Motycka and colleagues also emphasize the importance of self-assessment in pharmacy education, and the role it plays in the development of skills needed for independent learning as a practitioner. Additionally, they highlight that self-assessment plays an important role in the decision of a practitioner to ask for assistance when necessary.2 While it is undoubtedly true that self-assessment is an important tool to incorporate into pharmacy education, the results of the study at Monash University suggest that students often lack the ability to self-assess accurately. Motycka and colleagues make several recommendations to address this issue, including emphasizing external feedback, using learning tools that work in conjunction with feedback and self-assessment such as Objective Structured Clinical Examinations (OSCEs), and developing a “reflective thinking process.”2
For Doctor of Pharmacy programs, the Accreditation Council for Pharmacy Education requires “examples of tools used by students to document self-assessment of, and reflection on, learning needs, plans, and achievements and professional growth and development.”3 This highlights, again, the importance of introducing the concept of self-assessment early. However, simply incorporating self-assessment into the curriculum alone may not be sufficient for helping students develop lasting skills. Discussing the value of self-assessment, and how the practice benefits pharmacists at all points in their careers, may encourage students to place a higher value on developing these skills.
References
1. Abeyaratne C, Nhu T, Malone D. Self-Assessment of Therapeutic Decision-Making Skills in Pharmacy Students. Am J Pharm Educ. 2022;86(4):8696. doi:10.5688/ajpe8696
https://pubmed.ncbi.nlm.nih.gov/34507958/
2. Motycka CA, Rose RL, Ried LD, Brazeau G. Self-assessment in pharmacy and health science education and professional practice. Am J Pharm Educ. 2010 Jun 15;74(5):85. doi: 10.5688/aj740585. PMID: 20798800; PMCID: PMC2907850.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2907850/
3. Accreditation Council for Pharmacy Education. Ann Pharmacother. 2004;38(1):195-196. doi:10.1345/aph.1n044
https://www.acpe-accredit.org/pdf/Standards2016FINAL2022.pdf
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