The Effect of Performance Standards and Medical Experience on Diagnostic Calibration Accuracy

Purpose: Medical doctors do not always calibrate accurately in terms of their diagnostic performance, which means that their evaluation of their diagnosis differs from their actual performance. Inaccurate calibration can lead to maltreatment and increased health care costs. This study was conducted to investigate whether calibration accuracy can be improved among both board certified medical specialists and medical students by providing them with a simple form of feedback (i.e., performance standards). We expected that performance standards would enhance calibration accuracy. Furthermore, we expected that medical specialists would overall be better calibrated than medical students. Methods: Medical specialists (n=42) and medical students (n=43) diagnosed three clinical cases and rated their own performance, after which they did or did not receive standards (i.e., the correct diagnoses). All participants were then tested: they had to diagnose three new cases and had to rate their performance without receiving diagnostic feedback Results: In support of our hypotheses, findings indicate that both students and specialists who received performance standards calibrated better than students and specialists who did not receive standards. Furthermore, medical specialists calibrated better than medical students. Discussion: This study shows that providing simple forms of feedback constitute effects on calibration accuracy on new tasks. Keywords: Calibration, Feedback, Standards, Expertise, Self-assessmen