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The Perceived Ability of Gastroenterologists, Hepatologists and Surgeons Can Bias Medical Decision Making
Alessandro Cucchetti1,2, Dylan Evans3, Andrea Casadei-Gardini4
1Department of Medical and Surgical Sciences-DIMEC, S.Orsola-Malpighi Hospital, Alma Mater Studiorum-University of Bologna, 40138 Bologna, Italy.
Abstract:
Medical errors are a troubling issue and physicians should be careful to scrutinize their own decisions, remaining open to the possibility that they may be wrong. Even so, doctors may still be overconfident. A survey was here conducted to test how medical experience and self-confidence can affect physicians working in the specific clinical area. Potential participants were contacted through personalized emails and invited to contribute to the survey. The "risk-intelligence" test consists of 50 statements about general knowledge in which participants were asked to indicate how likely they thought that each statement was true or false. The risk-intelligence quotient (RQ), a measure of self-confidence, varies between 0 and 100. The higher the RQ score, the better the confidence in personal knowledge. To allow for a representation of 1000 physicians, the sample size was calculated as 278 respondents. A total of 1334 individual emails were sent to reach 278 respondents. A control group of 198 medical students were also invited, of them, 54 responded to the survey. The mean RQ (SD)of physicians was 61.1 (11.4) and that of students was 52.6 (9.9). Assuming age as indicator of knowledge, it was observed that physicians ≤34 years had a mean RQ of 59.1 (10.1); those of 35-42 years had 61.0 (11.0); in those of 43-51 years increased to 62.9 (12.2); reached a plateau of 63.0 (11.5) between 52-59 years and decreased to 59.6 (12.1) in respondents ≥60 years (r2:0.992). Doctors overestimate smaller probabilities and under-estimate higher probabilities. Specialists in gastroenterology and hepato-biliary diseases suffer from some degree of self-confidence bias, potentially leading to medical errors. Approaches aimed at ameliorating the self-judgment should be promoted more widely in medical education.
Insights
Physicians exhibit overconfidence, with higher risk-intelligence quotient (RQ) scores correlating with experience. This self-confidence bias, particularly in gastroenterology, may contribute to medical errors and necessitates improved self-judgment training in medical education.
Area of Science:
- Medical Education
- Cognitive Bias
- Physician Decision-Making
Background:
- Medical errors are a significant concern, potentially exacerbated by physician overconfidence.
- Understanding the relationship between medical experience, self-confidence, and decision-making is crucial for patient safety.
Purpose of the Study:
- To investigate the impact of medical experience on physician self-confidence using a risk-intelligence quotient (RQ) test.
- To assess potential self-confidence bias in physicians, particularly specialists.
Main Methods:
- A survey utilizing a 50-statement risk-intelligence test was administered to physicians and medical students.
- Risk-intelligence quotient (RQ) scores, measuring self-confidence, were compared between physicians and students, and across different physician age groups.
- Sample size was calculated for 1000 physicians, with 1334 emails sent to achieve 278 respondents; 54 out of 198 medical students responded.
Main Results:
- Physicians demonstrated a higher mean RQ (61.1) compared to medical students (52.6).
- Physician RQ scores peaked in the 52-59 age group and showed a slight decrease in older physicians (≥60 years).
- Physicians tended to overestimate small probabilities and underestimate high probabilities, indicating a self-confidence bias, especially noted in gastroenterology specialists.
Conclusions:
- Physician self-confidence, as measured by RQ, generally increases with age up to a point, but a bias in probability estimation persists.
- Self-confidence bias in physicians, particularly specialists, poses a risk for medical errors.
- Medical education should incorporate strategies to enhance physician self-judgment and mitigate overconfidence.
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