Perceived Level Of Confidence Research Articles

The Incidence of Overconfidence and Underconfidence Effects in Medical Student Examinations

Overconfidence is the tendency to overestimate the knowledge, capacity, or performance one really possesses. This cognitive bias could be potentially dangerous in medical decision-making, considering the impact it could have on patient health care. The aim of this study was to evaluate the incidence of overconfidence and underconfidence in medical student knowledge on general surgery by using traditional and new statistical approaches. During the application of a multiple-choice examination, 251 next-to-graduate medical students were invited to express the accuracy of their responses by choosing their own perceived confidence level for a set of questions. Analysis was done by comparing the difference between percentage of right answers (student's actual knowledge or accuracy) and self-estimated confidence level (student's perceived knowledge or confidence). Overconfidence was defined as a positive difference between confidence and accuracy, and underconfidence as a negative difference. Nearly 12% of students showed significant overconfidence regarding their actual knowledge or accuracy levels. Better students showed a lower overconfidence effect than students with poorer performance. On the other hand, underconfidence was less likely than overconfidence (8.3% of students), and that effect was most frequently found in students who performed better in examinations. The small proportion of our students exhibiting overconfidence or underconfidence behaviors moderates the need for educational interventions. Nevertheless, promoting prudence in individualized students manifesting overconfidence, and trust in those reporting significant underconfidence could increase the reliability of medical judgment during their future professional life. Overconfidence in individuals with lower scores in examinations may depend on a ceiling-like effect, since worst ranked students have a wider upper margin to manifest their confidence perceptions. The most confident students showed higher scores in examinations than the less confident ones. From this point of view, confidence could be considered an essential ingredient of success in examination performance.

Effects of a service learning experience on confidence and clinical skills in baccalaureate nursing students

BackgroundCamp programs yield positive and lasting benefits for children. Integrating a summer camp into a nurse course with a service learning design fosters learning beyond the classroom and enhances community engagement. ObjectiveThe purpose of this study is to describe the nursing students' experience and perceived confidence after completing a service learning nursing course. DesignThis is a descriptive, qualitative research study that used reflection and a perceived confidence questionnaire. SettingThe study was conducted in a school of nursing and surrounding university campus facilities during the diabetes camp. ParticipantsThe participants (n=23) were nursing students who enrolled in the nursing course. MethodsAs part of the course requirements, students completed an eight item question confidence survey before and after the diabetes camp related to diabetes and camp management, and interpersonal abilities with patients, families, and healthcare professionals. Within 48–72h after diabetes camp, the students completed the reflection paper. The pre and post Confidence Surveys were analyzed using a t-test and thematic analysis was used to analyze the reflection paper. ResultsOverall, perceived confidence levels increased after completing the service learning course (t=−9.91, p=0.001). Four themes emerged from the qualitative analysis: pre-camp assumptions and fears, growth in confidence, understanding diabetes management in the community, and appreciation for learning beyond the classroom and hospital setting. ConclusionsThis service learning course provided nursing students the ability to not only develop diabetes clinical skills and perceived confidence, but also life skills including teamwork, leadership, and conflict resolution.

An Annual Urology Tutorial For Junior Doctors; Results Of A Multi-Centre Study

This article was migrated. The article was not marked as recommended. IntroductionUrology accounts for a significant proportion of acute surgical admissions. The current undergraduate and postgraduate teaching curriculum does not place a large emphasis on urology teaching or placement which is concerning. With the use of questionnaires, our multi-centre study aims to observe junior doctor's perceived confidence level in management of urological condition after the inclusion of a urology interactive tutorial in the postgraduate program.MethodsFoundation and core trainee across four district general and teaching hospitals in the UK were invited to attend a urology tutorial. Prior to the tutorial, all participants were given a questionnaire to explore their previous urology teaching exposure and their confidence level in managing urological conditions. An interactive tutorial was conducted which covered emergency urological presentations and some ward based problems. A post-tutorial questionnaire was given with the intention to observe any improvement in confidence level.ResultsA total of 68 junior doctors participated. Only 4% (n=3) had received adequate urology teaching previously. Only 1 person felt confident to competently manage all urological problems while 34% (n=23) felt capable to manage most urological presentations. All participating junior doctors were keen on extra urology teaching, with 97% (n=66) wanted the teaching to focus on emergency urology conditions. 62% (n=42) felt this will help to improve patient care and aid their future training jobs. Positive feedbacks were received after the teaching, with 93% (n=63) finding it very useful and 97% (n=66) reported an increased in confidence level. DiscussionThis multi-centre study provided supporting evidence that junior doctors do not feel adequately prepared to manage urological conditions in the acute setting. We observed that junior doctor's confidence level in managing such presentations can be improved with an inclusion of a teaching supplementation. We propose the inclusion of urology teaching in the foundation program teaching curricula.

Exercise Self-efficacy And Social Support In Community Training

Exercise self-efficacy, an individuals’ perceived confidence as it relates to a specific behavior, is positively related to behavior change and long term exercise adherence. Social aspects of exercise can also contribute to exercise self-efficacy. This is especially important in regards to the adult population due to the difficulty of transitioning to the maintenance phase of behavior change. PURPOSE: To determine the benefits that an EIMOC initiated Community Fitness Partners program has upon self-efficacy and social support, as monitored and structured exercise programs have been shown to improve upon these aspects. Individual personal training was completed in a group setting to expose participants to additional sources of social support. This study aims to investigate the relationship between this community setting, social support and exercise self-efficacy. METHODS: Subjects aged 44.0 ± 13.2y volunteered to participate in an 8 week structured group community fitness partner program. Subject characteristics include: body mass (74.0 ± 20.8 kg), height (1.65 ± 0.08 m), % BF (28.0 ± 8.2), HRrest (68 ± 10 bpm), and BPrest (124 ± 19 / 78 ± 9 mmHg). All subjects underwent pre and post participation screening to determine baseline and concluding health and fitness measures. Each individuals’ perceived confidence levels related to exercise were determined by the Self-efficacy For Exercise (SEE) Scale (Resnick & Jenkins, 2000). Participants completed the Social Support and Exercise Survey to identify influences from friends and family regarding exercise participation (Sallis et al., 1987). Paired sample t-tests were used to determine differences pre to post program. RESULTS: Pre and post measurements of SEE scores were 58.2 ± 18.8 and 63.7 ± 17.0 (p > 0.05). Pre and post measurements of family participation support were 20.4 ± 11.4 and 24.0 ± 13.5 (p > 0.05), respectively while the friend participation support measured at 17.6 ± 7.5 and 19.2 ± 12.1 (p > 0.05). Although the social support and self-efficacy data did not reach statistical significance, there is still a notable positive trend. CONCLUSION: Overall most individuals experienced an increase in efficacy and social support values. Therefore, a group personal training protocol may be beneficial in the improvement of exercise self-efficacy and social support.

The sound of confidence and doubt

Feeling of knowing (or expressed confidence) reflects a speaker's certainty or commitment to a statement and can be associated with one's trustworthiness or persuasiveness in social interaction. We investigated the perceptual-acoustic correlates of expressed confidence and doubt in spoken language, with a focus on both linguistic and vocal speech cues. In Experiment 1, utterances subserving different communicative functions (e.g., stating facts, making judgments) produced in a confident, close-to-confident, unconfident, and neutral-intending voice by six speakers, were then rated for perceived confidence by 72 native listeners. As expected, speaker confidence ratings increased with the intended level of expressed confidence; neutral-intending statements were frequently judged as relatively high in confidence. The communicative function of the statement, and the presence vs. absence of an utterance-initial probability phrase (e.g., Maybe, I'm sure), further modulated speaker confidence ratings. In Experiment 2, acoustic analysis of perceptually valid tokens rated in Experiment 1 revealed distinct patterns of pitch, intensity and temporal features according to perceived confidence levels; confident expressions were highest in fundamental frequency (f0) range, mean amplitude, and amplitude range, whereas unconfident expressions were highest in mean f0, slowest in speaking rate, with more frequent pauses. Dynamic analyses of f0 and intensity changes across the utterance uncovered distinctive patterns in expression as a function of confidence level at different positions of the utterance. Our findings provide new information on how metacognitive states such as confidence and doubt are communicated by vocal and linguistic cues which permit listeners to arrive at graded impressions of a speaker's feeling of (un)knowing.

Perceived confidence for injury self‑management increases for young men with mild haemophilia with the use of the mobile app HIRT?

Abstract Background: Young men with mild haemophilia have unique challenges pertaining to bleed management. They may not always identify musculoskeletal injury requiring medical attention as they do not bleed frequently, potentially resulting in significant health consequences. In response to these challenges, a team of clinicians, researchers and young men with mild haemophilia developed a self-assessment pathway which was converted into a mobile app. Aim: This study examined the influence of the mobile app, HIRT? (Hemophilia Injury Recognition Tool) on perceived injury self-management in young men with mild haemophilia in Canada. Methods: We used a mixed methods design. The quantitative data, through a self-report questionnaire, evaluated perceived injury self-management strategies and participant confidence levels. Non-parametric Wilcoxon signed-rank test and McNemar chi-square test were used to determine association between perceived self-management strategies when using and not using the app, with significant levels set at p<0.05. Qualitative data was created using interpretive description and inductive content analysis of recorded and transcribed interviews. Results: 12 young men, aged 18-35 years, participated. Perceived confidence levels significantly increased (p=0.004) with the use of the app. Five qualitative themes were identified: accessibility, credibility, the benefit of alarms, confidence and usefulness. Conclusion: This study provides promising evidence to support the feasibility and use of HIRT? as an injury self-management tool for young men with mild haemophilia. Future research should prospectively investigate the effect of the app on injury selfmanagement confidence.

Implementing an in Situ Mock Code Quality Improvement Program.

The high risk and low volume of medical emergencies, combined with long periods between training sessions, on 2 progressive care units at Mayo Clinic, Rochester, Minnesota, established the importance of transforming how nursing staff are trained to respond to medical emergencies. To increase confidence levels and improve nursing performance during medical emergencies via in situ simulation. An in situ, mock code quality improvement program was developed and implemented to increase nurses' confidence while improving nursing performance when responding to medical emergencies. For 2 years, each unit conducted mock codes and collected data related to confidence levels and response times based on the recommendations in the 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. In those 2 years, nursing staff response times for calling for help improved 12%, time elapsed before initiating compressions improved 52%, and time to initial defibrillation improved 37%. Additionally, staff showed an increase in perceived confidence levels. Staff reported their appreciation of the opportunity for hands-on practice with the equipment, reinforcing their knowledge and refining their medical emergency skills. In situ mock codes significantly improve response times and increase staff confidence levels. In situ mock codes are a quick and efficient way to provide hands-on practice and allow staff to work as a team.

Developing confidence in mental health students to recognise and manage physical health problems using a learning intervention

Globally, there is increased recognition of a higher prevalence of physical ill health and mortality in individuals with mental health problems. A review of the literature highlighted the need to address deterioration in physical health of those with mental health problems through better recognition and management on the part of mental health nurses. However, mental health nurses have been found to lack confidence and be unsure of their role within this area. The aim of the project was to develop pre-registration mental health students' confidence to be able to recognise and manage physical health deterioration through the use of high fidelity human patient simulation, the development of contextualised clinical scenarios and additional theory around the A to E mnemonic structured assessment. The project involved 95 third year mental health student nurses, using a self-rating pre and post intervention questionnaire to measure their perceived confidence levels and to evaluate the effectiveness of the learning intervention. Findings demonstrate improved overall confidence levels in recognising and managing physical health deterioration in human patient simulators displaying mental health problems.

Can Learning the ISBARR Framework Help to Address Nursing Students' Perceived Anxiety and Confidence Levels Associated With Handover Reports?

Standardized communication frameworks are believed to help students feel more confident and less anxious about handover reports. One of the handover communication frameworks being used in nursing programs was the ISBARR framework (Identify, Situation, Background, Assessment, Recommendation, and Repeat). The aim was to explore whether learning the ISBARR framework affected nursing students' perceived anxiety and confidence levels associated with handover reports. The study tested null hypotheses by analyzing pre- and posttest data collected with the Competitive State Anxiety Inventory-2 (CSAI-2) survey. Three qualitative questions were included in the posttest to compare with the quantitative data. Statistical significance was set at p = .02. The results revealed that learning the framework had a strong effect in reducing the perceived somatic anxiety levels, a medium effect on increasing perceived confidence levels, and a medium effect in reducing the perceived cognitive anxiety levels. Findings suggested that learning the standardized framework may help to address students' perceived anxiety and confidence levels associated with handover reports and generate a mental picture of handover reports.

Board 417 - Research Abstract Bedside Ultrasound in Clinical Diagnoses

Introduction/Background Ultrasound is a low cost, noninvasive, rapidly performed examination that Results in reduced test to treatment times. As a result ultrasound is becoming a ubiquitous imaging modality in many hospital systems.1-5 However, there is limited literature on ultrasound training and use in internal medicine departments. We sought to determine the current ability of internal medicine residents to image abdominal organs and whether training on the Vimedix Ultrasound Simulator influenced their accuracy immediately after and at onemonth follow-up. We also sought to determine any change in their perceived level of confidence. Methods IRB approval was obtained. Twelve third year and 13 first year medicine residents participated in the study. Residents with prior certification in ultrasound were excluded. All participants completed a questionnaire to self-rate their confidence scanning abdominal organs. Participants were then assigned to the Vimedix normal “patient” or one of five pathology programs (selected based upon their frequency on floors Renal Cyst, Cholecystitis with Cholelithiasis, Hepatic Abscess, Small and Large Ascites ). Participants were told the patient had abdominal pain and were asked to use ultrasound to make a diagnosis. Performance scores and time to diagnosis were recorded. Scan time of four minutes was alloted. Performance scores were determined by: 1) 5 points - correct diagnosis/pathology/organ; 2) 1 point - each organ scanned correctly as normal; 3) 1 point - scan-time < than 4 minutes; 4) 1 point - deducted for over diagnoses/pathology/organ. All participants were provided with a short booklet describing scanning techniques for each abdominal organ. Half of the group was randomly trained with a five minute demonstration on the simulator. The same scanning exercise was repeated at 24 hours and one month. Students ’t’ test was used for statistical analyses. Results All participant groups demonstrated statistically significant increase in their performance scores after minimal ultrasound training. All groups maintain improvement from baseline at the one month follow-up but a decrease from the 24 hour performance. Both booklet alone and booklet with simulation-based demonstration group had similar performance increases. First year resident’s baseline mean performance score was 3.4 pts and 4.5 organs scanned, vs. 24 hour follow up (booklet alone 10 pts. (P = 0.001), with booklet and demo 13.5 pts. (P=0.0001), and 8.9 organs scanned), and 1 month follow up (booklet alone 8 pts. (P=0.019), booklet and demo 7 pts. (P=0.017) with 5.3 organs scanned). Third year resident’s baseline mean performance score was 4.5 pts. with 6 organs scanned vs. 24 hour follow up (booklet alone 13 pts. (P=0.0013), booklet and demo 13.8 pts. (P=0.0001), with 8 organs scanned) and 1 month follow up (booklet alone 9 pts. (P=0.021), booklet and demo 8 pts. (P=0.094), with 6 organs scanned. The mean perceived confidence level of all participants increased from 4.1 to 5.3 with training. Conclusion The resident’s performance scores increased with minimal instruction. The training booklet alone and booklet with bedside demonstration resulted in similar levels of performance increase. After training, residents seemed more able to identify normal organs resulting in a decrease in overdiagnosis. Training also helped the residents adopt a systematic approach allowing them to scan more organs in the same time duration. Additionally the 1 year residents with training outperformed 3 year residents without training suggesting that an extremely limited but focused training session may be a more effective training modality than years of passive observation. Performance levels of all participants at the 1 month interval remained improved from the baseline assessment but showed some decay from the 24 hour interval; this may indicate a need for additional training for retention and skill maintenance. Larger studies are required for stronger demonstration of the efficacy of bedside ultrasound training.

Lessons on Child Protection: A Survey of Newly Qualified Primary‐Level Teachers in Ireland

Do all newly qualified primary‐level teachers report the same experience of child protection practices in their schools? Drawing on findings from a recent Irish study, this paper will consider the operation of official child protection guidelines in schools based on the reported awareness and knowledge of a sample of newly qualified teachers. Their knowledge of child protection guidelines pertains to experience of induction into child protection practices upon taking up employment in the school and their awareness of a designated liaison person, school child protection policy and the procedures for reporting a suspected child protection issue within the school. The findings of this research indicate that schools' compliance with national guidelines on child protection is certainly inconsistent and such an ad hoc approach can be seen to impact on the perceived confidence levels of newly qualified teachers in dealing with child protection issues in the school. Given the crucial role teachers play in the safeguarding of children and the potential for strengthening this role, this paper argues for the standardisation of the operation of child protection procedures across all schools and the provision of training for all school staff. Copyright © 2013 John Wiley &amp; Sons, Ltd.‘This paper argues for the standardisation of the operation of child protection procedures’Key Practitioner Message There is a clear need for enhanced, standardised pre‐service and in‐school child protection training. New entrants to the teaching profession should automatically be inducted into the school child protection policy. Schools should have clearly articulated child protection policies and action plans which are consistently communicated to staff on a regular basis. The potential for teachers to promote child welfare and protection should be acknowledged and realised.

Confidence or confusion: how well are today’s Newly Qualified Teachers in England prepared to meet the additional needs of children in schools?

Faced with growing numbers of pupils with special needs, as well as those whose first language is not English, head teachers are increasingly faced with the challenge of employing Newly Qualified Teachers who require not only a different type of skills and knowledge base but the necessary personal qualities to effectively respond to the ‘Every Child Matters’ and ‘Extended Schools’ agendas. In more recent years, teaching has come under intense scrutiny, with suggestions being made in some quarters that many teachers entering the profession are ill-prepared and that following expensive appointment processes many are leaving the profession after only a short period of employment. This article explores the perceived confidence levels of student teachers in their final year, prior to entering the profession in regard to meeting the needs of children with a range of complex needs. The research forms part of a three-year project supported by ESCalate.

Assessment literacy development: identifying gaps in teacher candidates’ learning

As a result of the standards‐based movement in education there is an increased need for teacher competency in the area of student assessment and evaluation. This study examines assessment education at one pre‐service teacher education program in Ontario, Canada. Through a questionnaire administered to 288 teacher candidates, this study identified teacher candidates’ perceived confidence levels in assessment practice, theory, and philosophy. These teacher candidates also provided their views towards assessment topics that it is important to include in a pre‐service educational assessment course. Descriptive statistics, factor analysis, and analysis of variance were used to analyse questionnaire responses. In general, findings support the need for direct instruction in assessment with specific topics identified (e.g. reporting achievement, modifying assessments, developing constructed‐response items, item reliability, validity, articulating a philosophy of assessment, etc.) as important to developing teacher assessment literacy.

A Survey of the Understanding of the Adults with Incapacity Act in an Edinburgh Teaching Hospital.

Background: The Adults with Incapacity (Scotland) Act 2000 allows doctors and others to act on behalf of adult patients deemed incapable of making, communicating or understanding decisions, by reason of mental disorder or inability to communicate due to physical disability.Aims: We reviewed the knowledge and understanding of the Act in a sample of healthcare workers in a Teaching Hospital. Methods: A sample of healthcare workers working in acute Medicine of the Elderly wards in the Royal Infirmary of Edinburgh was surveyed between July and August 2009 with the aid of a questionnaire. Participants were then given a one-page information sheet about the Act, after which the questionnaire was repeated to assess learning. Results: Both questionnaires were analysed anonymously using paired t-tests. All eighteen doctors surveyed, twenty-one (87.5%) nurses and three (50%) auxiliaries were aware of the Act. The level of understanding and prior training in the Act varied amongst the groups. Specifically, knowledge regarding the role of relatives in decision making was poor in all cgroups. Perceived confidence levels in use of the Act were low.Provision of a simple information sheet significantly improved understanding of the Act in nurses (p=0.0001) and nursing auxiliaries p=0.0042, but not in doctors (p=0.1881).Conclusions: Awareness of the Adults with Incapacity (Scotland) Act 2000 varied amongst staff groups in an acute Medicine of the Elderly ward with doctors being more aware than other groups. Provision of a simple information sheet improved understanding of the Act in nurses and nursing auxiliaries but not in doctors who had a higher baseline knowledge.

Pediatricians' perceptions and practices regarding prevention and treatment of type 2 diabetes mellitus in children and adolescents.

To assess pediatricians' perceptions and practices regarding the prevention and treatment of type 2 diabetes mellitus in children and adolescents in a cross-sectional study. A 3-wave mailing of a questionnaire to 550 pediatricians. Descriptive statistics, analysis of variance, and logistic regression were used for data analyses. A national random sample of pediatricians who work in private practice, hospital settings, and/or clinics. Every 1 in 9 respondents referred their patients with type 2 diabetes mellitus for exercise, while most pediatricians referred their patients for dietary interventions (62.3%) and educational services (62.6%). Pediatricians who were confident during counseling and follow-up were significantly (P =.02) more likely than pediatricians who were less confident to refer their patients for exercise, dietary interventions, and educational services. Of the respondents, 15.3% perceived they were well prepared to counsel and provide follow-up to patients with type 2 diabetes mellitus. The leading perceived barriers to counseling and follow-up were inadequate time for counseling, poor adherence of patients, lack of family support, lack of familiarity of clinical practice recommendations, and lack of health care insurance coverage. Pediatricians who had a higher perceived confidence level and who perceived they were better prepared for the counseling and follow-up of patients with type 2 diabetes mellitus had a greater potential to positively affect their diabetic patients. Improving continuing medical education and residency-based programs is imperative to adequately address the emerging epidemic of type 2 diabetes mellitus in children and adolescents.

Approaches to Learning: a study of first-year geography undergraduates

This paper reports the findings of a survey conducted to investigate how a cohort of geography undergraduates approach learning. The learning approaches they adopt and how their perceived confidence levels change after one year in higher education are discussed. The students were exposed to a geography-based skills-development programme which emphasised a deep approach to learning. Results demonstrate that, although students' confidence levels in their ability to study and learn improved, they became increasingly instrumental in their approach to learning.

Approaches to Learning: A study of first-year geography undergraduates

This paper reports the findings of a survey conducted to investigate how a cohort of geography undergraduates approach learning. The learning approaches they adopt and how their perceived confidence levels change after one year in higher education are discussed. The students were exposed to a geography-based skills-development programme which emphasised a deep approach to learning. Results demonstrate that, although students' confidence levels in their ability to study and learn improved, they became increasingly instrumental in their approach to learning.