Knowledge self-monitoring, efficiency, and determinants of self-confidence statement in multiple choice questions in med
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RESEARCH ARTICLE
Open Access
Knowledge self-monitoring, efficiency, and determinants of self-confidence statement in multiple choice questions in medical students Nahid Tabibzadeh1* , Jimmy Mullaert2, Lara Zafrani3, Pauline Balagny1, Justine Frija-Masson4, Stéphanie Marin5, Agnès Lefort6, Emmanuelle Vidal-Petiot1 and Martin Flamant1*
Abstract Background: Multiple-choice question (MCQ) tests are commonly used to evaluate medical students, but they do not assess self-confidence nor penalize lucky guess or harmful behaviors. Based on a scoring method according to the appropriateness of confidence in answers, the study aimed at assessing knowledge self-monitoring and efficiency, and the determinants of self-confidence. Methods: A cross-sectional study of 842 s- and third-year medical students who were asked to state their level of confidence (A: very confident, B: moderately confident and C: not confident) during 12 tests (106,806 events). A bonus was applied if the level of confidence matched with the correctness of the answer, and a penalty was applied in the case of inappropriate confidence. Results: Level A was selected more appropriately by the top 20% students whereas level C was selected more appropriately by the lower 20% students. Efficiency of higher-performing students was higher when correct (among correct answers, rate of A statement), but worse when incorrect compared to the bottom 20% students (among incorrect answers, rate of C statement). B and C statements were independently associated with female and male gender, respectively (OR for male vs female = 0.89 [0.82–0.96], p = 0.004, for level B and 1.15 [1.01–1.32], p = 0.047, for level C). Conclusion: While both addressing the gender confidence gap, knowledge self-monitoring might improve awareness of students’ knowledge whereas efficiency might evaluate appropriate behavior in clinical practice. These results suggest differential feedback during training in higher versus lower-performing students, and potentially harmful behavior in decision-making during clinical practice in higher-performing students. Keywords: Evaluation, Students confidence, Gender confidence gap, Feedback, Efficiency
* Correspondence: [email protected]; [email protected] 1 Physiologie-Explorations Fonctionnelles, FHU APOLLO, Assistance Publique Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Université de Paris, CRI, INSERM, F-75018 Paris, France Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material.
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