The Incidence of Overconfidence and Underconfidence Effects in Medical Student Examinations
The Incidence of Overconfidence and Underconfidence Effects in Medical Student Examinations
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DOI：
10.1016/j.jsurg.2018.01.015
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发表时间：
2018-09-01
影响因子：
2.9
通讯作者：
Arribalzaga, Eduardo B.
中科院分区：
文献类型：
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作者：
Borracci, Raul A.;Arribalzaga, Eduardo B.
背景：过度自信是高估一个人真正拥有的知识、能力或表现的倾向。考虑到这种认知偏差可能对患者医疗保健产生的影响，这种认知偏差在医疗决策中可能是潜在的危险。本研究的目的是使用传统和新的统计方法来评估医学生普外科知识中过度自信和自信不足的发生率。方法：在多项选择考试中，251名即将毕业的医学生通过选择自己对一组问题的感知置信度来表达他们回答的准确性。分析是通过比较正确答案百分比(学生的实际知识或准确性)和自我估计的信心水平(学生感知的知识或信心)之间的差异来完成的。结果：近12%的学生对自己的实际知识或准确度水平表现出明显的过度自信。表现较好的学生比表现较差的学生表现出更低的过度自信效应。另一方面，自信不足的可能性低于自信过度(8.3%的学生)，这种影响最常出现在考试成绩更好的学生身上。结论：我们的学生表现出过度自信或自信不足行为的比例很小，这降低了教育干预的必要性。然而，在表现出过度自信的个性化学生中提倡谨慎，并信任那些报告严重自信不足的人，可能会增加他们未来职业生涯中医学判断的可靠性。对考试成绩较低的人的过度自信可能取决于一种类似天花板的效应，因为排名最差的学生有更大的上限来体现他们的自信认知。最自信的学生在考试中的分数比不自信的学生高。从这个角度来看，自信可以被认为是考试成绩成功的一个重要因素。(C)2018年外科项目主任协会。由Elsevier Inc.出版。保留所有权利。)
BACKGROUND: Overconfidence is the tendency to overestimate the knowledge, capacity, or performance one really possesses. This cognitive bias could be potentially dangerous in medical decision-making, considering the impact it could have on patient health care. The aim of this study was to evaluate the incidence of overconfidence and underconfidence in medical student knowledge on general surgery by using traditional and new statistical approaches.METHODS: During the application of a multiple-choice examination, 251 next-to-graduate medical students were invited to express the accuracy of their responses by choosing their own perceived confidence level for a set of questions. Analysis was done by comparing the difference between percentage of right answers (student's actual knowledge or accuracy) and self-estimated confidence level (student's perceived knowledge or confidence). Overconfidence was defined as a positive difference between confidence and accuracy, and underconfidence as a negative difference.RESULTS: Nearly 12% of students showed significant overconfidence regarding their actual knowledge or accuracy levels. Better students showed a lower overconfidence effect than students with poorer performance. On the other hand, underconfidence was less likely than overconfidence (8.3% of students), and that effect was most frequently found in students who performed better in examinations.CONCLUSIONS: The small proportion of our students exhibiting overconfidence or underconfidence behaviors moderates the need for educational interventions. Nevertheless, promoting prudence in individualized students manifesting overconfidence, and trust in those reporting significant underconfidence could increase the reliability of medical judgment during their future professional life. Overconfidence in individuals with lower scores in examinations may depend on a ceiling-like effect, since worst ranked students have a wider upper margin to manifest their confidence perceptions. The most confident students showed higher scores in examinations than the less confident ones. From this point of view, confidence could be considered an essential ingredient of success in examination performance. (C) 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)