Fellows-In-Training Self-Assessment: Use of a Self Perception of Competence (SPOC) Questionnaire

Rationale: To assist in achieving ACGME competencies and milestones, self-assessment and external assessment are needed. In 2006, we introduced a fellows’ self-assessment questionnaire to support information from multi-source “360” evaluations. The Self Perception Of Competence (SPOC) instrument consists of 37 questions. Likert scale was used with the terms novice, advanced beginner, competent, proficient, and expert. Examples of the questionnaire items include: “My ability to order and interpret spirometry is:”, and “My ability to present a topic independently at a seminar is:”. We explored patterns of SPOC responses to highlight patterns of progression during training.

Methods: We retrospectively analyzed responses for 18 fellows who completed the SPOC questionnaire at the beginning of fellowship, and thereafter at time intervals of 3, 6, 12, 18, and 24 months. Statistical analysis was done using a linear mixed model with ANOVA.

Results: Statistically significant differences were observed in SPOC scores over time, from entry to completing the program (p < 0.0001) and during the 1^st and 2^nd years of training (p < 0.0001).  There were statistically significant changes at each point of SPOC completion (p < .05).  The maximal increase in perceived level of competence was observed during the first three months of fellowship (p<0.0001).

Conclusions: We have found SPOC to be a useful learner self-assessment instrument for assessing progress in achieving ACGME competency-based programmatic goals and objectives during training. Response patterns in our program indicate that advances in fellows’ self-perceptions occurred in both the 1^st and 2^nd years, and were maximal in the first 3 months of training.