Department of Medical and Surgical Sciences-DIMEC, S.Orsola-Malpighi Hospital, Alma Mater Studiorum-University of Bologna, 40138 Bologna, Italy.
Morgagni-Pierantoni Hospital, 47121 Forlì, Italy.
Int J Environ Res Public Health. 2020 Feb 7;17(3):1058. doi: 10.3390/ijerph17031058.
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 (r: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.
医学错误是一个令人困扰的问题,医生应该仔细审查自己的决策,保持开放的态度,认识到自己可能犯错。即便如此,医生可能仍然过于自信。在这里进行了一项调查,以测试医学经验和自信如何影响在特定临床领域工作的医生。通过个性化电子邮件联系潜在参与者,并邀请他们参与调查。“风险智能”测试由 50 个关于一般知识的陈述组成,参与者被要求指出他们认为每个陈述是真实的还是虚假的可能性有多大。风险智能商数(RQ)是衡量自信程度的指标,范围在 0 到 100 之间。RQ 得分越高,个人知识的信心就越好。为了代表 1000 名医生,计算出的样本量为 278 名受访者。总共向 278 名受访者发送了 1334 封电子邮件。还邀请了一组 198 名医学生作为对照组,其中 54 名回应了调查。医生的平均 RQ(SD)为 61.1(11.4),学生的平均 RQ 为 52.6(9.9)。假设年龄是知识的指标,可以观察到 34 岁以下的医生平均 RQ 为 59.1(10.1);35-42 岁的医生为 61.0(11.0);43-51 岁的医生增加到 62.9(12.2);52-59 岁的医生达到 63.0(11.5)的平台期,60 岁以上的医生降至 59.6(12.1)(r:0.992)。医生高估较小的概率,低估较高的概率。胃肠病学和肝胆疾病专家存在一定程度的自信偏差,可能导致医疗错误。应在医学教育中更广泛地推广旨在改善自我判断的方法。