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How AI Agreement Shapes Confidence: Evidence Across Clinical Skill Levels
Federico Cabitza1,2, Alessia Papale1
1University of Milano-Bicocca, Milan, Italy.
Background:
Artificial intelligence (AI) is increasingly used in clinical workflows, but its psychological effects on diagnostic confidence remain unclear.
Objective:
To examine how agreement or disagreement with AI recommendations affects clinicians' confidence, and whether effects vary by skill level.
Methods:
Across three diagnostic domains, clinicians (N = 292) rated their diagnostic confidence before and after reviewing fixed-accuracy AI advice. Confidence change was analyzed by agreement/disagreement and user skills.
Results:
Agreement with AI increased confidence (M = 0.046), even when both human and AI were wrong (M = 0.048). Disagreement slightly reduced confidence (M = -0.008). These effects were consistent across skill levels.
Conclusion:
Agreement with AI acts as a cognitive reinforcer, increasing confidence regardless of correctness or user skill, revealing risks of overreliance in AI-supported diagnosis.
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