Pediatric Continuity Clinic Self-Assessment: A Framework for Competency-Based Self-Assessment

Abstract Self-assessment and self-directed learning are essential components of practice-based learning and improvement (PBLI). To demonstrate competency in PBLI, residents must be able to identify strengths, deficiencies, and limits in knowledge and expertise, and set learning and improvement goals. In addition, residents are required to maintain individualized learning plans (ILPs) to demonstrate competency in PBLI. Residents often have difficulty identifying specific learning needs and goals. The Continuity Clinic Self-assessment (CCSA) was originally developed as a resource for helping residents build ILPs. The CCSA asks residents to rate their confidence and perceived need for guidance in managing 40 clinical scenarios. The cases were selected based on national curriculum guidelines for pediatric continuity clinic and local educational needs. The cases are framed as one-sentence descriptions of common problems encountered in pediatric primary care. The instrument lends itself particularly well to guided reflection with a faculty mentor and tracking progress over time. The case scenarios can be changed easily to fit the needs of an individual program or discipline. The CCSA can be employed as a needs-assessment tool for curriculum planning, as a springboard for case-based teaching, or to evaluate the impact of training. As with most self-assessment exercises, some residents will be prone to over-rating and others will underestimate their abilities. Residents completing the self-assessment at multiple points in time (e.g., at the beginning and end of an academic year) may end up lowering their ratings over time. Faculty preceptors should be prepared to discuss and provide feedback on these aspects of residents' self-ratings.