A scoping review of self-monitoring in graduate medical education

Document Type

Journal Article

Publication Date



Medical education




BACKGROUND: Physicians and physicians-in-training have repeatedly demonstrated poor accuracy of global self-assessments, which are assessments removed from the context of a specific task, regardless of any intervention. Self-monitoring, an in-the-moment self-awareness of one's performance, offers a promising alternative to global self-assessment. The purpose of this scoping review is to better understand the state of self-monitoring in graduate medical education (GME). METHODS: We performed a scoping review following Arksey and O'Malley's six steps: identifying a research question, identifying relevant studies, selecting included studies, charting the data, collating and summarizing the results, and consulting experts. Our search queried Ovid Medline, Web of Science, PsychINFO, Eric, and EMBASE databases from 1 January 1999 to 12 October 2022. RESULTS: The literature search yielded 5363 unique articles. The authors identified 77 articles for inclusion. The search process helped create a framework to identify self-monitoring based on time- and context-dependence. More than 20 different terms were used to describe self-monitoring and only 13 studies (17%) provided a definition for the equivalent term. Most research focused on post-performance self-judgments of a procedural skill (n=31, 42%). Regardless of task, studies focused on self-judgment (n=66, 86%) and measured the accuracy or impact on performance of self-monitoring (n=41, 71%). Most self-monitoring was conducted post-task (n=65, 84%). CONCLUSION: Self-monitoring is a time and context dependent phenomenon that seems promising as a research focus to improve clinical performance of trainees in GME and beyond. The landscape of current literature on self-monitoring is sparse and heterogeneous, suffering from a lack of theoretical underpinning, inconsistent terminology, and insufficiently clear definitions.


Health, Human Function, and Rehabilitation Sciences