Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Feb 22:15:133-140.
doi: 10.2147/AMEP.S442689. eCollection 2024.

Overconfidence, Time-on-Task, and Medical Errors: Is There a Relationship?

Mohsin Al-Maghrabi  1 , Silvia Mamede  2 , Henk G Schmidt  3 , Aamir Omair  4   5   6 , Sami Al-Nasser  4   5   6 , Nouf Sulaiman Alharbi  4   5   6 , Mohi Eldin Mohammed Ali Magzoub  7
Affiliations

Overconfidence, Time-on-Task, and Medical Errors: Is There a Relationship?

Mohsin Al-Maghrabi et al. Adv Med Educ Pract. .

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

Keywords: diagnostic accuracy; medical errors; overconfidence; premature closure.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests in this work.

References

    1. Wu AW, Lipshutz AK, Pronovost PJ. Effectiveness and efficiency of root cause analysis in medicine. JAMA. 2008;299(6):685–687. doi: 10.1001/jama.299.6.685 - DOI - PubMed
    1. Gallagher TH, Studdert D, Levinson W. Disclosing harmful medical errors to patients. N Engl J Med. 2007;356(26):2713–2719. doi: 10.1056/NEJMra070568 - DOI - PubMed
    1. Conway J, Federico F, Stewart K, Campbell M. Respectful Management of Serious Clinical Adverse Events. In: IHI Innovation Series White Paper. 2nd ed. Cambridge, MA: Institute for Healthcare Improvement; 2011.
    1. Donaldson MS, Corrigan JM, Kohn LT. To Err is Human: Building a Safer Health System. USA: National Academies Press; 2000. - PubMed
    1. Leape LL, Berwick DM. Five years after to err is human: what have we learned? JAMA. 2005;293(19):2384–2390. doi: 10.1001/jama.293.19.2384 - DOI - PubMed