Self-assessment: With all its limitations, why are we still measuring and teaching it? Lessons from a scoping review.

INTRODUCTION: Self-Assessment (SA) is often assumed to be essential for learning, however, this assumption has been extensively rebutted. Research shows SA has significant limitations, including its lack of correlation with competence. METHOD: We undertook a scoping review of SA in medical education (2011-2021) and surprisingly discovered substantial research where SA was erroneously assumed to be a valid measure of successful learning, or a skill needing to be taught. Although the initial intent of our scoping review was to explore where SA is being effectively used to advance lifelong learning, we paused to explore the extent of the problem of its misuse and resulting in wasted research, by examining excluded studies. RESULTS: From 1151 articles, we identified 207 which ignored the documented limitations of SA. Thirty-nine studies explored SA of learning. This research has limited utility: increasing the accuracy of SA does not improve performance or lifelong learning. One hundred and sixty-eight used SA as an outcome measure to assess a program or intervention, including 63 where self-assessed improvement in knowledge/skills was the sole measure. SA of self-confidence was measured in 62 studies. When confidence was compared with an objective measure of performance, both invariably increased, but confidence did not always align with competence when measured. DISCUSSION: Many researchers mistakenly assume the ability to accurately self-assess is essential for learning, so focus on teaching self-calibration rather than evidence-based methods of advancing learning. Other researchers incorrectly suppose that self-reported improvements in knowledge/skills provide evidence of the efficacy of a program/intervention. This is particularly troubling with regards to novices, who may believe that because they self-assess to have improved/gained confidence, they are now competent. CONCLUSION: Our findings highlight the significant volume of research being done where SA is misunderstood and/or misused as a measurement. We posit reasons that such research continues to take place and suggest solutions moving forward.

A crisis is also an opportunity: GP teachers' views on continuing clinical placements in general practice during the evolving COVID-19 pandemic.

BACKGROUND AND OBJECTIVES: Early in the COVID-19 pandemic, some universities suspended student placements in general practice. The aim of this study was to explore the views of general practitioners (GPs) teaching in clinical practice ('GP teachers'). METHOD: Semi-structured interviews were held with 15 GP teachers in southeast Queensland from June to August 2020. RESULTS: Challenges included lack of masks and space, and concerns about infection control, medico-legal liability and student learning. Telehealth created more time for reflection and accessing information, increased student access to sensitive consultations, and provided opportunities to think-through rather than rote-do physical examinations. Students could be an extra pair of hands, also accessing and implementing the latest public health advice. GP teachers wanted clear communication and guidance from universities and for students to be trained in infection control and telehealth skills. DISCUSSION: Findings suggest that many GP teachers can be supported to continue clinical placements during an evolving crisis. The pandemic presented many challenges for general practice but also new opportunities for students to learn and contribute in practice.

Donsol: an important reproductive habitat for the world's largest fish Rhincodon typus?

Little is known about the reproductive ecology of the whale shark Rhincodon typus. On 15 March 2020, a free-swimming neonate whale shark was found in the shallow, coastal waters of Donsol, Philippines. The total length of the male shark was 60 cm, falling within the species known size-at-birth. This is the third occurrence of neonatal whale sharks reported in the area, and coupled with the occurrence of juveniles and adults, and anecdotal mating and precopulatory behaviour reported herein, the importance of the site for this endangered species is highlighted.

Development and evaluation of an interprofessional community health course in Zambia.

Persistent global health inequities and workforce shortage require innovative strategies to prepare professionals for teamwork in a global context. Over two years, students (n = 33) from education, nursing, occupational therapy, public health, and physical therapy participated in a course in Zambia that emphasized interprofessional collaborative practice (IPP), cultural fluency, and understanding ecological approaches to health. Faculty measured the learning outcomes of the course using the Interprofessional Education Collaborative (IPEC) Competency Self-Assessment Tool (pre and posttest), and a focus group to gain a deeper understanding of the student experience and course effectiveness. The Beliefs, Events and Values Inventory (BEVI) was used post trip to determine feasibility of distribution and response of the tool via e-mail. These preliminary results suggested that students developed skills and knowledge related to IPP, cultural fluency, and ecological approaches to health. Specifically, students acknowledged growth in their ability to communicate more effectively with other health professions, and ability to evaluate personal assumptions and biases toward health, healthcare, and cultural practices. The method of developing this course could be a model for other institutions wanting to grow IPP experiences for their students.

Patients' perceptions following laparoscopic sleeve gastrectomy: Sorry or satisfied?

BACKGROUND AND OBJECTIVES: Laparoscopic sleeve gastrectomy (LSG) currently accounts for 70.1% of weight-loss surgeries in Australia, according to the Bariatric Surgery Registry. There are limited qualitative studies examining Australian patients' experiences. The aim of this study was to explore patients' perspectives following LSG, providing information for shared decision making. METHOD: Twenty-two patients one, two or three years post-LSG were recruited randomly. Qualitative data were collected through in-depth telephone interviews, and responses were analysed inductively. RESULTS: Three global themes were identified: 1) normality, 2) control and 3) ambivalence, with eight organising sub-themes: 1) weight, 2) physical changes and daily living enhancements, 3) exercise, 4) emotional responses, 5) eating behaviour, 6) societal influences, 7) body image and 8) relationships. DISCUSSION: LSG is generally associated with high levels of patient satisfaction, with physical and psychosocial benefits beyond metabolic improvements. The decision to undergo this elective procedure should be made with an understanding of the significant and permanent effects it has on patients' lives.

Management of bariatric patients beyond the scalpel.

BACKGROUND: Obesity management in general practice sometimes involves referral of patients for bariatric surgery. Integral to the success of long-term weight loss maintenance is supporting the patient's psychological, nutritional and exercise needs. OBJECTIVE: This article is written to equip general practitioners (GPs) to manage the comprehensive needs, before and after bariatric surgery, of patients who are obese. DISCUSSION: The number of patients undergoing bariatric surgery in Australia has increased significantly in the past few years. Pre-operative and postoperative management of this intervention presents a challenge for GPs. In this article we provide guidance around psychological, nutritional and exercise interventions, to equip GPs in managing patients who are obese. Access to allied health providers is not always available for patients, so this article is co-written with allied health colleagues who share their expertise as a resource for GPs.