Discordance Between Perceived and Measured Procedural Competence in Trauma Surgery

Area of Science:

• Medical Education
• Surgical Skills Assessment
• Cognitive Bias in Medicine

Background:

• The Dunning-Kruger effect describes how individuals with low competence overestimate their abilities, while experts underestimate theirs.
• Understanding this effect in surgeons is crucial for assessing procedural competence.
• Surgeons' self-assessment of procedural skills remains poorly understood.

Purpose of the Study:

• To investigate the correlation between self-rated and objectively measured procedural competence in surgeons.
• To examine the Dunning-Kruger effect in the context of 29 specific trauma procedures.

Main Methods:

• 452 military general surgeons participated, with experience ranging from residents to over 20 years.
• Participants rated their perceived competence for 29 trauma procedures before a cadaver lab session.
• Expert trauma faculty directly assessed surgeons' performance during these procedures.

Main Results:

• Correlational analyses (Kendall tau) revealed no significant correlation between perceived and measured competencies (p < 0.05).
• Surgeons demonstrated overestimation of their procedural competence for 28 out of 29 procedures.
• This overestimation was evident when compared to independently assessed procedural performance.

Conclusions:

• The Dunning-Kruger effect was confirmed in the studied surgeon population.
• Surgeons consistently overestimated their abilities in most trauma procedures assessed.
• Findings highlight a potential disconnect between surgeon self-perception and actual procedural skill.