Confidence, Competence and Cadavers: Improving the Self-Perception of Practice through Practical Teaching.

Practical sessions using cadavers are one method of teaching clinical skills en masse to veterinary students, supporting students to learn the skills and gain the confidence to become Day One competent veterinarians. As confidence and competence are often conflated in Competency-Based Education approaches, in this study we used a pre-post survey design to evaluate 67 student self-ratings of confidence and self-assessed competence to explore whether a cadaver practical can change student confidence and self-assessed competence, and how comparable confidence and self-assessed competence are as measures. In a linear mixed effects model, we found that the practical improved the overall confidence score by 0.44 points (95% confidence interval [CI] [0.22, 0.66], t₍₁₂₀₎ = 3.97, p < .001). Self-assessed competence also increased by 0.60 (95% CI [0.41, 0.79], t₍₁₁₈₎ = 6.21, p < .001). However, although female students saw their overall self-assessed competence increase, they showed lower self-assessed competence scores by 0.87 points than males (95% CI [-1.47, -0.28], t₍₁₁₈₎ = -2.89, p = 0.005). Despite confidence and self-assessed competence being strongly associated, direct agreement between the measures in a weighted kappa test was weak (pre-practical κ_weighted = 0.49, [95% CI 0.33, 0.66], post-practical κ_weighted = 0.44, [95% CI 0.10, 0.28]). We discuss the implications of these findings.