Self-assessment accuracy of undergraduate paramedic students

The ability for a health professional to accurately assess and reflect on their own performance is considered an essential skill to deliver safe and effective care. This skill should begin in the student phase and as such, the ability of undergraduate healthcare students to accurately self-assess their academic performance needs to be understood. While research exists on the self-assessment ability of medical students, this study aims to determine the accuracy of paramedic students in predicting their written examination performance and the factors that impact accuracy. This pilot study used a cross-sectional, pre/post-study design. Participants were recruited from years one, two and three from the Bachelor of Emergency Health or Bachelor of Emergency Health & Nursing programs at Monash University. Using questionnaires, students were asked to predict their examination performance at three points in time: before undertaking their mid- and end-of-semester written examinations and also after undertaking the mid-semester examination. Three hundred students (out of a population of 316) participated in one or more of the three stages of this study. Eighty-eight percent of participants were under 26 years old and 35% of participants were male. The study revealed undergraduate paramedic students possessed some ability to predict their examination performance in the mid-semester examinations with weak correlation in the preexamination prediction (p=0.038, r=0.147) and moderate correlation in the post-exam prediction (p=<0.001, r=0.500) and no significant correlation in the end-of-semester examination. However at all three prediction points, the majority of students were not able to predict their performance within five percentage points, suggesting overall self-assessment accuracy is poor. There were several factors found to influence accuracy of prediction. Participants were marginally better at predicting their performance after undertaking the examination and accuracy appeared to improve as year level increased. There was a tendency for underachieving students to overestimate and overachieving students to underestimate their performance. The results were contextualised against existing literature, and aligned with some research but contrasted with others. Further study is needed to determine the ability of paramedic students' to self-assess, and it is recommended that qualitative elements are included to explore why some students are more accurate than others. The results of th is study also suggest that students undertake formative examinations incorporating self-assessment prior to summative assessments. Given the identified poor level of accuracy, formative exams may be needed to provide both the student and teacher with opportunity to obtain insight into the student's expectation and adjust study techniques prior to the summative assessment.