Does general experience affect self-assessment?

BACKGROUND: The assessment of clinical competence is critical in medical education. Understanding the effect of general experience on a physician's self-assessment would help design more effective curricula and evaluations of procedural skills in postgraduate training and continuing professional development (CPD). In this observational study, we assessed the effect of general experience on the correlation between confidence and competence amongst experienced clinicians (ECs) and postgraduate trainees (PGTs) when learning an office-based procedure in pessary care. METHODS: We recruited 19 first-year family medicine residents and 18 family medicine faculty members in two outpatient academic clinics. All participants attended a simulation-based workshop for a routine gynaecological office procedure. We used a confidence survey as a measure of the participants' self-assessed competence and an objective structured clinical examination (OSCE) to evaluate participants' competence before and after the workshop. The assessment of clinical competence is critical in medical education RESULTS: We found no significant correlation between confidence and competence at baseline for either group (EC, r = 0.25, p = 0.35; PGT, r = 0.15, p = 0.60). After the workshop, we observed a statistically significant correlation between confidence and competence for ECs (r = 0.60, p = 0.01), but not for PGTs. The change in this correlation was not statistically significant for either group, however. DISCUSSION: Our findings suggest that ECs are not any more accurate in the assessment of their competence compared with PGTs. All procedural skills curricula can benefit from OSCE-format evaluation to better evaluate the improvement in performance of participants.

Tyrosine phosphatase beta regulates angiopoietin-Tie2 signaling in human endothelial cells.

OBJECTIVES: The endothelial cell (EC)-selective receptor tyrosine kinase, Tie2, and its ligands angiopoietin Ang-1 and Ang-2, are essential for blood vessel maintenance and repair. Ang-1 is an agonist of Tie2 receptor activation, whereas Ang-2 is a context-dependent antagonist/agonist. Therefore, we investigated the role of the EC-selective phosphatase, human protein tyrosine phosphatase beta (HPTPbeta), in regulating Tie2 activity. METHODS AND RESULTS: siRNA silencing of HPTPbeta enhanced Ang-1 and Ang-2-induced Tie2 phosphorylation at 10 min (2.5-fold, P < 0.001; and 1.8-fold, P < 0.05, respectively). The cell survival response to Ang-1, but not Ang-2, was enhanced by HPTPbeta silencing as measured by flow cytometry (0.85-fold to 0.66-fold, P < 0.05) and ELISA (0.88-fold to 0.53-fold, P < 0.01). Hypoxia, which upregulated HPTPbeta expression in endothelial cells, impaired Ang-1-induced Tie2 phosphorylation. CONCLUSIONS: These results reveal a novel role for HPTPbeta in modulating Ang-1-Tie2 signaling and endothelial cell survival.