Exploring the learning curve in medical education: using self-assessment as a measure of learning.

BACKGROUND: Learning is a complex process that follows predictable patterns. The authors explored whether students' self-assessment of competencies could be used as a measure of learning within medical school. METHOD: Medical students (all grade levels) rated their achievement of competencies at the beginning and end of an academic year. Repeated-measures ANOVA and [eta]2 were used to determine differences. RESULTS: Five hundred thirty-three students participated (response rate = 79.3%). Self-assessment ratings between four grade levels were significant (P < .001, [eta]2 = 0.33), with the steepest difference between MS2 and MS3; professionalism ratings remained relatively stable. The largest percent increase within an academic year occurred between MS1 and MS2, with little increase within MS3 and MS4. CONCLUSIONS: Medical students' self-assessment ratings of competencies indicated differences between grade levels and during an academic year, following a sigmoidal curve. These results have implications for medical education and indicate the need to develop longitudinal measures to track changes in learning.