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Cited by 14Clinical Reasoning and Diagnostic SkillsDecision-Making and Behavioral EconomicsPatient Safety and Medication Errors

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

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Al-Maghrabi, Mohsin, Mamede, Silvia, Schmidt, Henk, Omair, Aamir, Al-Nasser, Sami, Alharbi, Nouf, Magzoub, Mohi Eldin·2024·Advances in Medical Education and Practice
DOI 10.2147/amep.s442689PMC PMC10896093
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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.

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  • Participants in the high-confidence group tended to overestimate their diagnostic accuracy, even though their actual performance was similar to that of the low-confidence group.

    “a study demonstrated that participants in the high-confidence group tended to overestimate their diagnostic accuracy, even though their actual performance was similar to that of the low-confidence group [104].”

    From Toward Safer Diagnoses: A SEIPS-Based Narrative Review of Diagnostic Errors (2026) · cites this paper as [104]

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References 23 · Cited by 14

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Authors
Al-Maghrabi, M., Mamede, S., Schmidt, H., Omair, A., Al-Nasser, S., Alharbi, N., & Magzoub, M. E.
Affiliations
  • Erasmus University Rotterdam (NL)
  • King Saud bin Abdulaziz University for Health Sciences (SA)
  • United Arab Emirates University (AE)
Corresponding author
Alharbi, Nouf
ORCID
Venue
Advances in Medical Education and Practice
Publisher
Informa UK Limited
Published
2024-02
Volume
Volume 15
Pages
133-140
ISSN
1179-7258 (ISSN-L)
DOI
10.2147/amep.s442689
PMC
PMC10896093
OpenAlex
W4391996814
Cited by
14
References
23
Citations by year
2026: 7 · 2025: 6 · 2024: 1
FWCI
7.77
Type
journal article
Language
en
Open access
Licence
Locations
  • Advances in Medical Education and Practice (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • EUR Research Repository (Erasmus University Rotterdam) (publishedVersion, cc-by-nc)
  • Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
Topics
  • Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
  • Social Sciences › Decision Sciences › General Decision Sciences › Decision-Making and Behavioral Economics
  • Health Sciences › Health Professions › Emergency Medical Services › Patient Safety and Medication Errors
Keywords
overconfidence, medical errors, diagnostic accuracy, time on task, cognitive biases, internal medicine residents, clinical vignettes, physician confidence

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