Open Access Open Badges Research article

Comparison of the medical students’ perceived self-efficacy and the evaluation of the observers and patients

Jette Ammentorp1*, Janus Laust Thomsen2, Dorte Ejg Jarbøl2, René Holst3, Anne Lindebo Holm Øvrehus4 and Poul-Erik Kofoed15

Author Affiliations

1 Health Services Research Unit, Lillebaelt Hospital/IRS University of Southern Denmark, Vejle, Denmark

2 Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, Denmark

3 Department of Biostatistics, Institute of Regional Health Service Research University of Southern Denmark, Odense, Denmark

4 Education Development Unit, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark

5 Department of Paediatrics, Kolding Hospital, Kolding, Denmark

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BMC Medical Education 2013, 13:49  doi:10.1186/1472-6920-13-49

Published: 8 April 2013



The accuracy of self-assessment has been questioned in studies comparing physicians’ self-assessments to observed assessments; however, none of these studies used self-efficacy as a method for self-assessment.

The aim of the study was to investigate how medical students’ perceived self-efficacy of specific communication skills corresponds to the evaluation of simulated patients and observers.


All of the medical students who signed up for an Objective Structured Clinical Examination (OSCE) were included. As a part of the OSCE, the student performance in the “parent-physician interaction” was evaluated by a simulated patient and an observer at one of the stations. After the examination the students were asked to assess their self-efficacy according to the same specific communication skills.

The Calgary Cambridge Observation Guide formed the basis for the outcome measures used in the questionnaires.

A total of 12 items was rated on a Likert scale from 1–5 (strongly disagree to strongly agree).

We used extended Rasch models for comparisons between the groups of responses of the questionnaires. Comparisons of groups were conducted on dichotomized responses.


Eighty-four students participated in the examination, 87% (73/84) of whom responded to the questionnaire. The response rate for the simulated patients and the observers was 100%.

Significantly more items were scored in the highest categories (4 and 5) by the observers and simulated patients compared to the students (observers versus students: -0.23; SE:0.112; p=0.002 and patients versus students:0.177; SE:0.109; p=0.037). When analysing the items individually, a statistically significant difference only existed for two items.


This study showed that students scored their communication skills lower compared to observers or simulated patients. The differences were driven by only 2 of 12 items.

The results in this study indicate that self-efficacy based on the Calgary Cambridge Observation guide seems to be a reliable tool.

Self-assessment; Self-efficacy; Calgary Cambridge observation guide; Communication skills training