Medical student self-assessment of performance on an obstetrics and gynecology clerkship.
OBJECTIVE: The purpose of this study was to evaluate the accuracy of medical student self-assessment of performance on an obstetrics and gynecology clerkship and to assess the influence that demographic and temporal factors had on the accuracy of that assessment. STUDY DESIGN: From June 1990 to July 2000, 1152 students predicted examination and clerkship grades at the beginning and end of their obstetrics and gynecology clerkship. The effects of class rank, gender, rotation length, semester, prediction type, and timing on the accuracy of prediction were evaluated with logistic regression. RESULTS: Students more often correctly predicted clerkship than examination grades. Students with higher grades tended to underestimate their performance; the students who received lower grades tended to overestimate their performance. All factors had a significant effect on the outcome (all, P <.001). Odds ratios for the overestimation were greatest for the lower one third of the class compared with the upper one third of the class (odds ratio, 4.38) and for students who completed the 6-week clerkship compared with the 8-week clerkship (odds ratio, 3.61) CONCLUSION: Better performing medical students tend to underestimate their performance; poorer performing students tend to overestimate their performance. Below-average students have the potential to derive the most benefit from formal feedback.