Is insight important? Measuring capacity to change performance
Article first published online: 17 OCT 2002
Volume 36, Issue 10, pages 965–971, October 2002
How to Cite
Hays, R. B., Jolly, B. C., Caldon, L. J. M., McCrorie, P., McAvoy, P. A., McManus, I. C. and Rethans, J.-J. (2002), Is insight important? Measuring capacity to change performance. Medical Education, 36: 965–971. doi: 10.1046/j.1365-2923.2002.01317.x
- Issue published online: 17 OCT 2002
- Article first published online: 17 OCT 2002
- Received 21 March 2002; editorial comments to authors 15 May 2002, 17 June 2002; accepted for publication 26 June 2002
- Clinical competence/*standards;
- physicians, family/*standards;
- education, medical, continuing/*standards;
- quality of health care/standards
Background Some doctors who perform poorly appear not to be aware of how their performance compares with accepted practice. The way that professionals maintain their existing expertise and acquire new knowledge and skills – that is, maintain their ‘currency’ of practice – requires a capacity to change. This capacity to change probably requires the individual doctor to possess insight into his or her performance as well as motivation to change. There may be a range of levels of insight in different individuals. At some point this reaches a level which is inadequate for effective self-regulation. Insight and performance may be critically related and there are instances where increasing insight in the presence of decreasing performance can also cause difficulties.
Objective This paper presents an exploration into the nature of insight, its relationship to professional performance and its measurement as part of performance, reflecting the combined experiences of a group of experienced education researchers and the results of literature searches on insight and performance.
Conclusion There may be individuals in whom insight is so lacking that they are beyond remediation. If there is a dichotomy between adequate and inadequate levels of insight, testing this could be a cost-effective way of determining where efforts for remediation should be focussed.