Overconfident health workers provide lower quality healthcare

Abstract

Overconfident health workers provide lower quality healthcareWhile a growing body of evidence suggests that healthcare workers in low and middle-income countries often provide poor quality of care, the reasons behind such low performance remain unclear. The literature on medical decision-making suggests that cognitive biases, or failures related to the way healthcare providers think, explain many diagnostic errors. This study investigates whether one cognitive bias, overconfidence, defined as the tendency to overestimate one's performance relative to others, is associated with the low quality of care provided in Senegal.We link survey data on the overconfidence of health workers to objective measures of the quality of care they provide to standardised patientsenumerators who pose as real patients and record details of the consultation. We find that about a third of providers are overconfidentmeaning that they overestimate their own abilities relative to their peers. We then show that overconfident providers are 26% less likely to manage patients correctly and exert less effort in clinical practice.These results suggest that the low levels of quality of care observed in some settings could be partly explained by the cognitive biases of providers, such as overconfidence. Policies that encourage adequate supervision and feedback to healthcare workers might reduce such failures in clinical decision-making.

Does high workload reduce the quality of healthcare? Evidence from rural Senegal

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Do task and item difficulty affect overestimation of one’s hand hygiene compliance? A cross-sectional survey of physicians and nurses in surgical clinics of six hospitals in Germany

“…Overconfidence, defined as "greater confidence than reality justifies" [1, p. 1], has been termed "one of the most consistent, powerful and widespread" among psychological biases [2, p. 317] and the "rarely addressed mother of all biases" in medicine [3, p. 127]. To date, overconfidence in medicine has been primarily studied as a cause of diagnostic errors [4,5], and one study found poor case management by overconfident health care workers [6]. As regards infection prevention and control (IPC), particularly hand hygiene, overconfidence has been argued to represent a barrier to professionals' compliance with interventions to prevent health care-acquired infections (HAIs) in some but, given pertinent clinical experiences, surprisingly few studies [7][8][9][10].…”

Overconfidence in news judgments is associated with false news susceptibility

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