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Related Concept Videos

Self-Discrepancy Theory02:45

Self-Discrepancy Theory

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One influential perspective on what motivates people's behavior is detailed in Tory Higgin's self-discrepancy theory (Higgins, 1987). He proposed that people hold disagreeing internal representations of themselves that lead to different emotional states.  
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Confidence Coefficient01:24

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The confidence coefficient is also known as the confidence level or degree of confidence. It is the percent expression for the probability, 1-α, that the confidence interval contains the true population parameter assuming that the confidence interval is obtained after sufficient unbiased sampling; for example, if the CL = 90%, then in 90 out of 100 samples the interval estimate will enclose the true population parameter. Here α is the area under the curve, distributed equally under...
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Self-Discrepancy and Its Effects01:29

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Self-discrepancy theory explains how people compare their actual self to their ideal and ought selves and how mismatches between these self-guides can lead to emotional distress. Developed by E. Tory Higgins, the theory distinguishes among three components of self-concept: the actual self, the ideal self, and the ought self. These refer respectively to how individuals perceive themselves, how they aspire to be, and how they believe they are obligated to be. Emotional well-being, self-esteem,...
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Confidence Intervals01:21

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An unbiased point estimate is often insufficient to predict a population estimate, such as population mean or population proportion. In this scenario, a confidence interval is used. A confidence interval is an estimate similar to a  sample proportion. However, unlike the point estimate which is a single value, the confidence interval  contains a range of values. These values have lower and upper limits, known as confidence limits, and can be designated as L1 and L2, respectively.
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Interpretation of Confidence Intervals01:19

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A confidence interval is a better estimate of the population than a point estimate, as it uses a range of values from a sample instead of a single value.
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Uncertainty: Confidence Intervals00:54

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The confidence interval is the range of values around the mean that contains the true mean. It is expressed as a probability percentage. The interpretation of a 95% confidence interval, for instance, is that the statistician is 95% confident that the true mean falls within the interval. The upper and lower limits of this range are known as confidence limits. The confidence limits for the true mean are estimated from the sample's mean, the standard deviation, and the statistical factor...
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Related Experiment Video

Updated: Feb 15, 2026

An R-Based Landscape Validation of a Competing Risk Model
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Case Reporting, Competence, and Confidence: A Discrepancy in the Numbers.

Deepa Shah1, Carl E Haisch2, Seth L Noland3

  • 1Department of Surgery, East Carolina University, Greenville, North Carolina.

Journal of Surgical Education
|February 4, 2018
PubMed
Summary
This summary is machine-generated.

Surgical resident case logs do not reliably indicate operative competency. Resident confidence in vascular procedures does not correlate with technical skill, highlighting the need for direct assessment of operative technique.

Keywords:
Patient Careintraoperative evaluationoperative competencyoperative confidenceresident education

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Area of Science:

  • Medical Education
  • Surgical Training
  • Competency Assessment

Background:

  • The Accreditation Council for Graduate Medical Education (ACGME) uses case logs to evaluate surgical resident competency.
  • Assessing operative proficiency and technical skills is crucial for graduating residents.

Purpose of the Study:

  • To compare the number of vascular cases logged by surgical residents with their actual operative proficiency, anastomosis quality, experience, and confidence.
  • To evaluate the reliability of ACGME case logs in reflecting resident surgical competence.

Main Methods:

  • General surgery residents (PGY 1-5) performed simulated vascular anastomoses, assessed using a validated Global Rating Scale.
  • Residents completed surveys on operative experience (Zwisch scale) and confidence (1-9 scale).
  • Case log data was correlated with simulation scores, Milestones, and confidence levels; intraoperative assessments were also conducted.

Main Results:

  • No correlation was found between the number of logged vascular cases and simulation performance scores (p = 0.94).
  • Resident confidence in vascular procedures (mean 6.67/9) did not correlate with the quality of their anastomosis.
  • Most residents reported their experience as 'Smart Help,' indicating a discrepancy between perceived and actual involvement.

Conclusions:

  • ACGME case logs may not accurately reflect a resident's operative competency or technical proficiency.
  • Resident confidence is not a reliable indicator of technical surgical ability.
  • Direct assessment of resident operative technique is the most effective measure of surgical competency.