Developing self-assessment skills amongst doctors in Nepal.

Background: Accurate self-assessment is essential to direct life-long learning. Most research on self-assessment is from the West. This study takes place in Kathmandu, Nepal.

Aim: To develop tools to aid the development of self-assessment skills in Nepali doctors.

Methods: Fifteen doctors were asked to complete three self-assessment tasks per month over a 6-month period; one mini-clinical evaluation exercise, one clinical case review and one significant event analysis. Self-assessment was compared with mentor assessment for each task. Changes over time for each individual were noted. Results were analyzed using SPSS 10.0. Self and tutor scores were compared using Pearson's correlation coefficient. Reliability of the tools was assessed using Cronbach's Alpha. Participants completed a qualitative questionnaire regarding each tool.

Results: All three tools had high content and face validity, as well as reliability. The use of the "intra individual" approach, with multiple assessments over time demonstrated that most doctors were able to accurately self-assess in some areas. Feedback from a senior tutor was vital. Doctors appreciated feedback that was immediate, specific and delivered in a safe environment. Even where self-assessment was less accurate, the process itself helped to develop awareness of key learning issues.

Conclusions: These self-assessment tools are feasible, reliable and valid for the hospital setting in Nepal.