Background:\ud We demonstrate the phenomenon of ‘incompetent and unaware’ in a real world setting.\ud Summary of work:\ud Medical students (193) participated in a self-assessment exercise, requiring predictions of exam grade in 3 domains; knowledge, skills, and behaviours. The exercise was completed 3 times; immediately after January exams, one week after January exams and immediately after May exams. Feedback on assessment ability was given between January and May. Personality type was correlated with self-assessment ability. Students assessed the Conscientiousness Index (CI) scores of themselves and peers. \ud Summary of results:\ud Failing students over predicted their exam performance. Merit students under assessed performance, and pass students accurately self-assessed. Students’ ability to self-assess was not improved after a week of contemplation. Feedback improved failing students’ ability to self-assess but had no impact upon under-assessing merit students. Students were unable to predict their CI scores, but were able to assess peers’ scores. Ability to self-assess was not related to personality type.\ud Conclusions:\ud Ability to self-assess was consistent across physical skills and cognitive aptitudes, but not attributes (conscientiousness). \ud Take home messages:\ud Failing students can become more self-aware with respect to exam performance if they are given appropriate feedback. Self-awareness is crucial for success; students need more guidance on this. \u
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