The limitations of the study include a sample size of 195
students from one academic year. Further research might
examine performance across multiple years and multiple institutions,
thus increasing the sample. Additionally, this study
examined only outcomes during a surgery clerkship, but it
would be interesting to see whether the aforementioned
findings are consistent in other specialties where procedures
are routinely done such as obstetrics and/or gynecology or
family medicine. Further research is needed to determine
whether it is possible to improve self-assessment skills
through a curriculum change. There is some limited educational
research with suggestions on methods to enhance
student self-assessment, although this has not been well
established in the medical education realm. Sadler [20] suggests
students develop “appraisal expertise” where students
generate assessment criteria, create rubrics, or examine potential
criteria and assess their relevance, which will lead to
improved self-assessment skills. He also advocates increased
use of “purposeful peer assessment” where students acquire
the ability to critically appraise their own work by examining
the work of others. This has also been demonstrated by Kostons
et al. [21] that modeling and practicing self-assessment
behavior can lead to improved self-assessment skills and
behavior. Further research can be conducted to develop and
evaluate pedagogical models that improve medical student
self-assessment skills and may impact lifelong learning.