The Self-assessment in Systematic Comprehensive Clinical Assessment: A Pillar for the Development of Clinical Competence.

Abstract

Introduction. Self-assessment is crucial for the development of clinical competence; however, further exploration of the validity and feasibility of these modules within objective assessment systems is needed.
Objective. Describe the reliability (internal consistency) and perform a comparative descriptive analysis (averages and perceptions) of the self-assessment module within the Systematic Comprehensive Clinical Evaluation (ECIS) system in medical students.
Method. A descriptive, cross-sectional, non-experimental design was used. Data from 10 institutional SCIAs were analyzed over 5 years (5 in the basic cycle, 5 in the clinical cycle). The total sample included 552 second-year students and 439 fourth-year students. The analysis was limited to descriptive statistics (means, standard deviations, and frequencies) for validity and perception, and to calculating Cronbach's alpha for reliability.
Results. The competencies assessed by the ECIS evolved from fundamental skills (interrogation, examination, presumptive diagnosis in the basic cycle) to the integration of study request and interpretation (clinical cycle). The internal consistency of the self-assessment rubric was acceptable in the basic cycle (α = 0,75) and good in the clinical cycle (α = 0,82). A consistent overestimation of performance by students relative to evaluators was observed, with an average difference of +0.98 (SD 0.9) points in the second year and +0.36 (SD 0.8) points in the fourth year. Evaluators and students expressed high satisfaction with the module's usefulness and impact (87% of evaluators and 86% of students selected "Strongly Agree" or "Agree").
Limitations. It is acknowledged that students' self-assessments of their performance are subjective and tend to result in systematic overestimation.
Originality. The value of this research lies in its holistic approach to evaluating clinical competence, integrating self-assessment as a fundamental pillar rather than a peripheral exercise.
Conclusion. The self-assessment module demonstrates acceptable internal validity and reliability and enjoys high user acceptance, suggesting its potential as a training tool that promotes reflection on and understanding of performance standards.

Keywords: Medical education; clinical competence; assessment; self-assessment; clinical reasoning.