Demigods of Technology Use – How Beating the Overconfidence Bias Can Prevent Medical Errors

The healthcare domain faces considerable challenges due to the digitization of medical processes and routines. Information technologies are designed to enable physicians to treat more patients and to increase service quality and patient safety. Despite acknowledging the rapid digital transformation of healthcare, research often neglects whether physicians are actually able to effectively decide which technology to use in which setting and whether their technology use thus effectively enhances quality and safety. Literature on cognitive biases already looked broadly at related errors in judgment and action and questioned rational behavior. Nevertheless, overconfidence, being one of the most common cognitive biases, has barely been linked to the accurate adoption and use of technology by physicians. Against this background, this research-in-progress paper proposes a framework for conducting a mixed-methods study based on the particularities of overconfidence in healthcare. We invite future research to compare our approach with established theoretical frameworks in IS research

Overconfident health workers provide lower quality healthcare

While 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 patients – enumerators who pose as real patients and record details of the consultation. We find that about a third of providers are overconfident – meaning 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

Israeli pediatricians’ confidence level in diagnosing and treating children with skin disorders: a cross-sectional questionnaire pilot study

BackgroundPediatricians daily see large numbers of patients with skin disorders. However, they encounter limited guidance as a result of a marked deficiency in pediatric dermatologists. Hence, reevaluation of training opportunities during pediatric residency has become essential. Our aim was to evaluate the confidence level of pediatric residents and specialists in diagnosing and treating skin disorders in children and to determine career and training-related characteristics that influence it.MethodsConducted as a cross-sectional study, we administered a questionnaire to 171 pediatricians across Israel. We assessed respondents’ self-efficacy about their ability to diagnose and treat skin disorders and collected data regarding their previous dermatology training and preferred training methods.Results77.8% of respondents reported below or average self-efficacy scores in diagnosing and managing children with skin disorders. Older age (>40 years old; OR = 5.51, p = 0.019), treating a higher number of patients with skin disorders (OR = 2.96, p = 0.032), and having any training in dermatology, either during medical school or residency (OR = 7.16, p = 0.031, OR = 11.14, p = 0.003 respectively), were all significant parameters involved in pediatricians reporting high self-efficacy in skin disorder management.ConclusionMost pediatric residents and pediatricians have average or below-average confidence in managing pediatric skin disorders. We suggest incorporating dermatology rotations during pediatric residency to improve young pediatricians’ self-efficacy in managing skin disorders and ultimately help pediatricians provide better care for patients presenting with dermatological conditions. These findings can ultimately help refine a pilot program in dermatology that might be implemented during pediatric residency

Expertise, credibility of system forecasts and integration methods in judgmental demand forecasting

YesExpert knowledge elicitation lies at the core of judgmental forecasting—a domain that relies fully on the power of such knowledge and its integration into forecasting. Using experts in a demand forecasting framework, this work aims to compare the accuracy improvements and forecasting performances of three judgmental integration methods. To do this, a field study was conducted with 31 experts from four companies. The methods compared were the judgmental adjustment, the 50–50 combination, and the divide-and-conquer. Forecaster expertise, the credibility of system forecasts and the need to rectify system forecasts were also assessed, and mechanisms for performing this assessment were considered. When (a) a forecaster’s relative expertise was high, (b) the relative credibility of the system forecasts was low, and (c) the system forecasts had a strong need of correction, judgmental adjustment improved the accuracy relative to both the other integration methods and the system forecasts. Experts with higher levels of expertise showed higher adjustment frequencies. Our results suggest that judgmental adjustment promises to be valuable in the long term if adequate conditions of forecaster expertise and the credibility of system forecasts are met