Self-assessment in the health professions: a reformulation and research agenda.

Many researchers and educators have identified self-assessment as a vital aspect of professional self-regulation.1,2,3 This rationale has been the expressed motivation for a large number of studies of self-assessment ability in medical education, health professional education, and professions education generally. Unfortunately, the outcome of most studies would seem to cast doubt on the capacity for self-assessment, with the majority of authors concluding that selfassessment is, in fact, quite poor.4 In a recent article, Ward and colleagues suggested that this conclusion must be questioned because the methodologies used to evaluate self-assessment are fraught with methodological weaknesses.4 However, even studies that have attempted to address the weaknesses within the methodological paradigm have produced little evidence for effective selfassessment.5 Thus, the health professional education community is left with a conundrum that can only be resolved by deciding either that the conclusions of the studies are wrong, or that a critical premise underlying the concept of “selfregulation” in the professions is unsupportable.