Al-Maghrabi Mohsin, Mamede Silvia, Schmidt Henk G, Omair Aamir, Al-Nasser Sami, Alharbi Nouf Sulaiman, Magzoub Mohi Eldin Mohammed Ali
Department of Pediatrics, Imam Abdulrahman Alfaisal Hospital, Riyadh, Saudi Arabia.
Institute of Medical Education Research Rotterdam, Erasmus University Rotterdam, Rotterdam, the Netherlands.
Adv Med Educ Pract. 2024 Feb 22;15:133-140. doi: 10.2147/AMEP.S442689. eCollection 2024.
Literature suggest that physicians' high level of confidence has a negative impact on medical decisions, and this may lead to medical errors. Experimental research is lacking; however, this study investigated the effects of high confidence on diagnostic accuracy.
Forty internal medicine residents from different hospitals in Saudi Arabia were divided randomly into two groups: A high-confidence group as an experimental and a low-confidence group acting as a control. Both groups solved each of eight written complex clinical vignettes. Before diagnosing these cases, the high-confidence group was led to believe that the task was easy, while the low-confidence group was presented with information from which it could deduce that the diagnostic task was difficult. Level of confidence, response time, and diagnostic accuracy were recorded.
The participants in the high-confidence group had a significantly higher confidence level than those in the control group: 0.75 compared to 0.61 (maximum 1.00). However, neither time on task nor diagnostic accuracy significantly differed between the two groups.
In the literature, high confidence as one of common cognitive biases has a strong association with medical error. Even though the high-confidence group spent somewhat less time on the cases, suggesting potential premature decision-making, we failed to find differences in diagnostic accuracy. It is suggested that overconfidence should be studied as a personality trait rather than as a malleable characteristic.
文献表明，医生的高度自信会对医疗决策产生负面影响，这可能导致医疗差错。然而，缺乏实验研究。本研究调查了高度自信对诊断准确性的影响。
来自沙特阿拉伯不同医院的40名内科住院医师被随机分为两组：一组为高自信组作为实验组，另一组为低自信组作为对照组。两组都要解答八个复杂的书面临床病例。在诊断这些病例之前，高自信组被引导相信任务很容易，而低自信组则被告知一些信息，从中可以推断出诊断任务很困难。记录自信水平、反应时间和诊断准确性。
高自信组参与者的自信水平明显高于对照组：分别为0.75和0.61（最高为1.00）。然而，两组在任务用时和诊断准确性方面均无显著差异。
在文献中，高度自信作为常见的认知偏差之一，与医疗差错密切相关。尽管高自信组在病例上花费的时间略少，表明可能存在过早决策的情况，但我们未能发现诊断准确性上的差异。建议将过度自信作为一种人格特质而非可塑特征来研究。
