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

Mohsin Al-Maghrabi, Silvia Mamede, Henk G. Schmidt, Aamir Omair, Sami Al-Nasser, Nouf Sulaiman Alharbi*, Mohi Eldin Mohammed Ali Magzoub

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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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.

Original languageEnglish
Pages (from-to)133-140
Number of pages8
JournalAdvances in Medical Education and Practice
Publication statusPublished - 22 Feb 2024

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Publisher Copyright: © 2024 Al-Maghrabi et al.


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