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Just as overdetection and overdefinition contribute to a risk of overdiagnosis or misdiagnosis, so does overconfidence. Physicians in general tend to underappreciate the likelihood that their diagnoses are wrong, because of overconfidence in their diagnostic abilities. Overconfidence in intuitive thinking, through long experience, can lead to misdiagnosis when analytical thinking is suppressed; fewer errors are made when both intuitive and analytical thinking are engaged. Furthermore, those who are overconfident tend to adduce evidence that supports their diagnosis and reject evidence that does not. Overconfidence can be bred during medical training. Poorly performing students are more confident in their abilities than their performances suggest, although they also report less confidence in their predictions. Surprisingly, high fidelity (highly realistic) simulation teaching, say with mannekins, may lead to overconfidence and equal or even worse performance and growth in knowledge than low fidelity simulation. Hindsight bias, the tendency to exaggerate the extent to which a past event could have been predicted beforehand, also tends to induce overconfidence.

Original publication

DOI

10.1136/bmj.o2145

Type

Journal article

Journal

The BMJ

Publication Date

01/01/2022