Are public health workers aware of what they don't know?

Objectives: Training of public health workers is an important part of preparedness. Self-assessment is often used to measure how well workers are trained and whether they are ready to respond to an emergency event. The current study assessed how well self-assessment predicts actual knowledge.

Methods: Public health workers at a Public Health Ready pilot site self-assessed their general level of confidence, answered objective knowledge items about their local response plan, and self-assessed whether they were correct on the objective knowledge items. Correlational analysis was used to assess how well workers could assess what they knew and did not know.

Results: In the first analysis, for 15 objective knowledge items, the median correlation between self-assessment and actual performance was 0.18. When the average self-assessment on the core competencies was correlated with the number of correct answers to the objective knowledge items, the correlation was 0.34.

Conclusions: The modest sizes of the correlations suggest that workers are weak judges of what they know and do not know. To prepare public workers for emergency events, it is suggested that two steps are important: (1) using the core competencies, develop a local response plan, and (2) develop an objective knowledge test to assess workers' knowledge of the local response plan.