Self-assessment or self deception? A lack of association between nursing students' self-assessment and performance

J Adv Nurs. 2011 Nov;67(11):2406-13. doi: 10.1111/j.1365-2648.2011.05658.x. Epub 2011 Apr 26.


Aim: The aim of this study was to examine senior year nursing students' ability to self-assess their performance when responding to simulated emergency situations.

Background: Self-assessment is viewed as a critical skill in nursing and other health professional programmes. However, while students may spend considerable time completing self-assessments, there is little evidence that they actually acquire the skills to do so effectively. By contrast, a number of studies in medicine and elsewhere have cast doubt on the validity of self-assessment.

Method: In 2007, a one-group pre-test, post-test design was used to answer the question, 'How accurate are senior year nursing students in assessing their ability to respond to emergency situations in a simulated medical/surgical environment compared to observer assessment of their performance?' A total of 27 fourth year nursing students from a university in Ontario were asked to complete a questionnaire before and after an objective structured clinical examination which assessed their ability to respond to emergency situations. Self-assessments were compared with observed performance.

Findings: The experience of dealing with the simulated crisis situations significantly increased perceived confidence and perceived competence in dealing with emergency situations, although it did not affect self-perceived ability to communicate or collaborate. All but 1 of the 16 correlations between self-assessment and the objective structured clinical examination total scores were negative. Their self-assessment was also unrelated to several indices of experience in critical care settings.

Conclusion: Self-assessment in nursing education to evaluate clinical competence and confidence requires serious reconsideration as our well-intentioned emphasis on this commonly used practice may be less than effective.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Clinical Competence*
  • Deception
  • Education, Nursing / methods*
  • Educational Measurement / standards*
  • Emergencies / nursing
  • Female
  • Humans
  • Nursing Education Research
  • Ontario
  • Randomized Controlled Trials as Topic
  • Self-Assessment*
  • Students, Nursing / psychology*
  • Surveys and Questionnaires
  • Young Adult