Subjective Confidence Research Articles

A Hysteroscopy Simulation Program for Intern Safety [27B

INTRODUCTION: Hysteroscopy is a fundamental gynecologic skill that allows direct visualization of the uterine cavity. Many residency programs have incorporated simulation activities into their training. The objective of this study was to determine if a simulation program using a virtual reality resectoscope would improve medical knowledge, surgical skill, and confidence of residents performing a hysteroscopy. METHODS: A pre-posttest model was used to assess the effectiveness of implementing a simulation curriculum into obstetrics and gynecology residency training. The primary components of the curriculum included didactic review, demonstration and practice using a hysteroscopy simulator. Outcomes were measured comparing knowledge test scores, performance assessments using a validated scoring system (percent of pathology removed, safety, economy, visualization, and fluid handling) and subjective surveys to assess comfort and confidence with hysteroscopic procedures. RESULTS: Six interns participated in the simulation program. The mean knowledge exam score improved 37.9 percentage points (95% CI 21.2–54.6, P<.01), the average overall simulator score improved 28.3 percentage points (95% CI 13.9–42.8, P<.01), and the percentage of simulator categories that each individual completed at goal improved 26.5 percentage points (95% CI 13.6–39.5, P<.01). The subjective surveys indicated a significant improvement in confidence with hysteroscopy from 1.8 to 4.1 on a 5-point Likert scale (95% CI 1.6–3.1, P<.01). CONCLUSION: Trainees experienced statistically significant improvements in knowledge, surgical skill assessments, and subjective confidence related to hysteroscopic procedures. Implementing a formal simulation curriculum to novice residents yields rapid improvements to hone skills in a less pressured environment in order to safely operate on future patients.

Translation and validation of the Karitane Parenting Confidence Scale in Nepali language

Backgrounda mother׳s lack of confidence in the early postnatal period may negatively influence their ability to care for their infant. Parenting confidence contributes to the parent-infant relationship and other aspects of infant development. The Karitane Parenting Confidence Scale is a 15-item self-report questionnaire designed to measure parents’ subjective confidence in their parenting abilities, or ‘perceived parenting self-efficacy’, and is designed for mothers with infants aged 0–12 months. Objectivesto translate the Karitane Parenting Confidence Scale into Nepali language and assess the validity and reliability among Nepalese postnatal mothers. Designcross-sectional study. Settingoutpatient department of maternity and women׳s hospital in Kathmandu, Nepal. Participantsone hundred postnatal mothers within 5–6 weeks of childbirth were recruited using the convenience sampling method. Methodsfollowing back-translation procedures, mothers completed questionnaires during follow-up visit at immunisation/postnatal clinics. For the validity and reliability have been assessed internal consistency, discriminant validity, and construct validity. Resultsthe translated Karitane Parenting Confidence Scale mean score was 35.47±5.48, ranging from 32 to 42. Cronbach׳s alpha coefficient for internal consistency was 0.87. A difference was found between primiparous and multiparous mothers׳ confidence scores. There was a significant correlation between maternal confidence and anxiety scores. Demographic response patterns suggest that the maternal confidence level was affected by education level. Conclusionsthe Nepali version of Karitane Parenting Confidence Scale showed adequate reliability and validity. Therefore, the Nepali Karitane Parenting Confidence Scale is considered a suitable instrument to assess maternal confidence in Nepali postnatal mothers.

Validation of post mortem dental CT for disaster victim identification

Abstract The objective of this study was to test the accuracy and inter-reader variability of comparative radiologic identification based on dental post mortem computed tomography (PMCT) and ante mortem (AM) dental radiographs. Five raters with varying degrees of expertize and experience independently compared 115 dental PMCT images to 114AM dental radiographs to identify matching pairs ( n =98), unmatched PMCT images ( n =17), and unmatched AM radiographs ( n =16). Levels of confidence (LOC) and number of concordant features (NOCF) of matched pairs were documented. Accuracy of matches/exclusions, interrater correlation coefficient and correlation between correct matches/exclusions, LOC and NOCF were calculated for all raters. Mean accuracy was 92% for matches and 80% for exclusions. Interrater correlation coefficient regarding LOC and NOCF were 0.623 and 0.907 respectively. LOC were correlated with NOCF of matched pairs but accuracy of matches/exclusions was neither correlated to LOC nor to NOCF. This study shows that visual comparison of PMCT images with AM dental radiographs is a reliable method for identification. Accuracy of identification using PMCT/AM dental radiographs was as high as in comparable studies using post mortem (PM) dental radiographs/AM dental radiographs. Raters with practical experience in forensic identification and experience with the imaging modality (in this case: dental PMCT) achieved higher accuracy than inexperienced raters. Match accuracy did not correlate with subjective confidence or number of concordant features. It is advised to work in teams rather than individually when dealing with real cases in forensic identification, to minimize subjective interpretation and avoid confirmation bias.

Confidence as a Common Currency between Vision and Audition.

The idea of a common currency underlying our choice behaviour has played an important role in sciences of behaviour, from neurobiology to psychology and economics. However, while it has been mainly investigated in terms of values, with a common scale on which goods would be evaluated and compared, the question of a common scale for subjective probabilities and confidence in particular has received only little empirical investigation so far. The present study extends previous work addressing this question, by showing that confidence can be compared across visual and auditory decisions, with the same precision as for the comparison of two trials within the same task. We discuss the possibility that confidence could serve as a common currency when describing our choices to ourselves and to others.

Greater response cardinality indirectly reduces confidence

ABSTRACTKoriat's Self-Consistency Model of subjective confidence proposes that the consistency and accessibility with which a response is retrieved are cues to confidence in the accuracy of that response. The Self-Consistency Model, however, has only been assessed using two-alternative forced-choice questions. Consideration of open-ended questions suggested that response cardinality—the number of unique response options that might come to mind—should directly reduce response consistency, and thus indirectly reduce confidence. Australian undergraduate students (N = 389) completed a 20-item open-ended general-knowledge test with confidence ratings attached to each answer. Replicating previous Self-Consistency Model findings, but in an open-ended format for the first time, consistency and accessibility were independent positive predictors of confidence, though the prediction of accessibility did not reach statistical significance. Extending the model, the number of unique responses given by participants, a measure of response cardinality, was found to be a strong negative predictor of consistency and indirect negative predictor of confidence. Implications of the results therefore include the use of simple strategies such as prompting or providing varying numbers of response options as potentially effective for manipulating cardinality and thus confidence.

Financial Literacy and Long- and Short-Term Financial Behavior in Different Age Groups

The purpose of this study was to examine the relationship between financial literacy and financial behaviors among various age groups. Financial literacy was measured in three ways: objective financial knowledge, subjective financial knowledge or confidence, and subjective financial management ability. The age groups were 18–24, 25–34, 35–44, 45–54, 55–64, and 65 and older. Long-term financial behavior referred to retirement saving and investing behavior, whereas short-term financial behavior referred to spending and emergency saving behavior. In the full sample, both objective and subjective financial literacy variables were positively associated with long- and short-term financial behaviors. In the age subsamples, subjective financial knowledge or confidence was more strongly related to long- and short-term financial behavior than either objective financial knowledge or subjective financial management ability in the younger age groups. In the older age groups, objective financial knowledge was more strongly related to long-term financial behavior than either of the other two measures of financial literacy.

Behavioural Biases in Investment Decision Making: A Research Study on Individual's Overconfidence

Individuals sometimes act with excessive self-reliance resulting self-confidence gets converted to overconfidence. The overconfidence is a well-established bias in which a person's subjective confidence in her/his judgments rules over the objective accuracy of those judgments. As a result of that, the outcome gets influenced. It is observed that overconfidence may generate in three ways, e.g. overestimation, overplacement and overprecision. Investment decision making also gets affected by the influence of individual's overconfidence and it comes in the above three ways. This primary research study had been initiated to examine if individuals are really getting affected by the overconfidence bias or not. It is strongly evidenced that individuals exhibit overconfidence while executing investment decision making. Sometimes they consider their price as optimum, sometimes they consider the timing is perfect. They also consider themselves skilled and knowledgeable to identify the “good” stocks. They do not pay any importance on the contradictory opinion because they are overconfident that they can predict the future stock price perfectly. Their overconfidence influence adversely the decision making process leading to a serious error in judgement in many occasions.

Aging, source memory, and the experience of “remembering”

ABSTRACTIn a previous study, we found source memory for perceptual features to differentiate between younger but not older adults’ reports of recollective (“remember”; R) and “know” (K) experiences. In two experiments with younger (17–30 years) and older (64–81 years) participants, we examined whether memory for meaningful speaker sources would accompany older adults’ recollective experience. Indeed, memory for male and female speakers (but not partial memory for gender; Experiment 1) as well as bound memory for speakers and their facial expressions (Experiment 2) distinguished between both younger and older adults’ RK reports. Thus, memory for some sources forms a common basis for younger and older adults’ retrieval experience. Nonetheless, older adults still showed lower objective source memory and lower subjective source-attribution confidence than younger adults when reporting recollective experiences, suggesting that source memory is less relevant to their retrieval experience than for younger adults.

Application of Cervical Collars - An Analysis of Practical Skills of Professional Emergency Medical Care Providers.

Background/ObjectiveThe application of a cervical collar is a standard procedure in trauma patients in emergency medicine. It is often observed that cervical collars are applied incorrectly, resulting in reduced immobilization of the cervical spine. The objective of this study was to analyze the practical skills of trained professional rescue personnel concerning the application of cervical collars.Material and MethodsWithin emergency medical conferences, n = 104 voluntary test subjects were asked to apply a cervical collar to a training doll, wherein each step that was performed received an evaluation. Furthermore, personal and occupational data of all study participants were collected using a questionnaire.ResultsThe test subjects included professional rescue personnel (80.8%) and emergency physicians (12.5%). The average occupational experience of all study participants in pre-clinical emergency care was 11.1±8.9 years. Most study participants had already attended a certified training on trauma care (61%) and felt "very confident" in handling a cervical collar (84%). 11% applied the cervical collar to the training doll without errors. The most common error consisted of incorrect adjustment of the size of the cervical collar (66%). No association was found between the correct application of the cervical collar and the occupational group of the test subjects (trained rescue personnel vs. emergency physicians) or the participation in certified trauma courses.ConclusionDespite pronounced subjective confidence regarding the application of cervical collars, this study allows the conclusion that there are general deficits in practical skills when cervical collars are applied. A critical assessment of the current training contents on the subject of trauma care must, therefore, be demanded.

Subjective probability, confidence, and Bayesian updating

I define subjective probabilities for an ambiguity averse agent who is given an exogenous information set\(\varDelta \) containing the true probability law on the state space S. The agent in my model evaluates every uncertain prospect via a mixture of the least favorable scenario in \(\varDelta \) and her unique subjective beliefp. This parametric utility structure is characterized by four standard axioms—order, continuity, monotonicity, and Independence—where the last two conditions are modified via the information set \(\varDelta \). Any pair of preferences \(\succeq _1\) and \(\succeq _2\) in my model can be compared in terms of confidence—the weights attached to the subjective beliefs \(p_1\) and \(p_2\), respectively. The corresponding behavioral condition extends Epstein’s comparative ambiguity aversion that leaves some rankings \(\succeq _1\) and \(\succeq _2\) unrelated. Moreover, I relax the well-known dynamic consistency principle and characterize the Bayesian updating rule for the belief p conditional on any non-null event in S.

Wide of the mark: Evidence on the underlying causes of overprecision in judgment

Overprecision is the most robust and least understood form of overconfidence. In an attempt to elucidate the underlying causes of overprecision in judgment, the present paper offers a new approach – examining people’s beliefs about the likelihood of chance events drawn from known probability distributions. This approach allows us to test the assumption that low hit rates inside subjective confidence intervals arise because those confidence intervals are drawn too narrowly. In fact, subjective probability distributions are systematically too wide, or insufficiently precise. This result raises profound questions for the study of overconfidence.

Graphical Aids to the Estimation and Discrimination of Uncertain Numerical Data.

This research investigates the performance of graphical dot arrays designed to make discrimination of relative numerosity as effortless as possible at the same time as making absolute (quantitative) numerosity estimation as effortful as possible. Comparing regular, random, and hybrid (randomized regular) configurations of dots, the results indicate that both random and hybrid configurations reduce absolute numerosity estimation precision, when compared with regular dots arrays. However, discrimination of relative numerosity is significantly more accurate for hybrid dot arrays than for random dot arrays. Similarly, human subjects report significantly lower levels of subjective confidence in judgments when using hybrid dot configurations as compared with regular configurations; and significantly higher levels of subjective confidence as compared with random configurations. These results indicate that data graphics based on the hybrid, randomized-regular configurations of dots are well-suited to applications that require decisions to be based on numerical data in which the absolute quantities are less certain than the relative values. Examples of such applications include decision-making based on the outputs of empirically-based mathematical models, such as health-related policy decisions using data from predictive epidemiological models.

Lung CT Screening Reporting and Data System Speed and Accuracy Are Increased With the Use of a Semiautomated Computer Application

PurposeThe Lung CT Screening Reporting and Data System (Lung-RADS™) is an algorithm that can be used to classify lung nodules in patients with significant smoking histories. It is published in table format but can be implemented as a computer program. The aim of this study was to assess the efficiency and accuracy of the use of a computer program versus the table in categorizing lung nodules. MethodsThe Lung-RADS algorithm was implemented as a computer program. Through the use of a survey tool, respondents were asked to categorize 13 simulated lung nodules using the computer program and the Lung-RADS table as published. Data were gathered regarding time to completion, accuracy of each nodule’s categorization, users’ subjective categorization confidence, and users’ perceived efficiency using each method. ResultsThe use of a computer program to categorize lung nodules resulted in significantly increased interpretation speed (80.8 ± 37.7 vs 156 ± 105 seconds, P < .0001), lung nodule classification accuracy (99.6% vs 76.5%, P < .0001), and perceived confidence and efficiency compared with the use of the table. There were no significant differences in accuracy when comparing thoracic radiologists with the remainder of the group. ConclusionsRadiologists were both more efficient and more accurate in lung nodule categorization when using computerized decision support tools. The authors propose that other institutions use computerized implementations of Lung-RADS in the interests of both efficiency and patient outcomes through proper management. Furthermore, they suggest the ACR design future iterations of the Lung-RADS algorithm with computerized decision support in mind.

Comparison of the image qualities of filtered back-projection, adaptive statistical iterative reconstruction, and model-based iterative reconstruction for CT venography at 80 kVp.

To evaluate the subjective and objective qualities of computed tomography (CT) venography images at 80 kVp using model-based iterative reconstruction (MBIR) and to compare these with those of filtered back projection (FBP) and adaptive statistical iterative reconstruction (ASIR) using the same CT data sets. Forty-four patients (mean age: 56.1 ± 18.1) who underwent 80 kVp CT venography (CTV) for the evaluation of deep vein thrombosis (DVT) during 4months were enrolled in this retrospective study. The same raw data were reconstructed using FBP, ASIR, and MBIR. Objective and subjective image analysis were performed at the inferior vena cava (IVC), femoral vein, and popliteal vein. The mean CNR of MBIR was significantly greater than those of FBP and ASIR and images reconstructed using MBIR had significantly lower objective image noise (p < .001). Subjective image quality and confidence of detecting DVT by MBIR group were significantly greater than those of FBP and ASIR (p < .005), and MBIR had the lowest score for subjective image noise (p < .001). CTV at 80 kVp with MBIR was superior to FBP and ASIR regarding subjective and objective image qualities. • MBIR provides superior image quality compared with FBP and ASIR • CTV at 80kVp with MBIR improves diagnostic confidence in diagnosing DVT • CTV at 80kVp with MBIR presents better image quality with low radiation.

A nap to recap or how reward regulates hippocampal-prefrontal memory networks during daytime sleep in humans.

Sleep plays a crucial role in the consolidation of newly acquired memories. Yet, how our brain selects the noteworthy information that will be consolidated during sleep remains largely unknown. Here we show that post-learning sleep favors the selectivity of long-term consolidation: when tested three months after initial encoding, the most important (i.e., rewarded, strongly encoded) memories are better retained, and also remembered with higher subjective confidence. Our brain imaging data reveals that the functional interplay between dopaminergic reward regions, the prefrontal cortex and the hippocampus contributes to the integration of rewarded associative memories. We further show that sleep spindles strengthen memory representations based on reward values, suggesting a privileged replay of information yielding positive outcomes. These findings demonstrate that post-learning sleep determines the neural fate of motivationally-relevant memories and promotes a value-based stratification of long-term memory stores.

A task-independent neural representation of subjective certainty in visual perception.

Am I really sure? This is a question not only scientists ask themselves but practically everybody every day. A recent study provides behavioral evidence supporting the view that one’s subjective confidence in a decision (i.e., feeling sure that a decision is correct) is represented in a task-independent format. Previous neuroimaging studies identified neural correlates of decision confidence but whether or not these are task-dependent remains unclear. Here, combining two perceptual decision tasks with functional magnetic resonance imaging (fMRI), we provide neural evidence for a task-independent representation of degrees of subjective certainty (i.e., a neural representation of subjective certainty that remains constant across two visual tasks). Importantly, due to the constant stimulus-intensity used this result is independent of task-difficulty and stimulus properties. Our data provide strong evidence for a generic mechanism underlying the computation of subjective perceptual certainty in vision.

Modeling Self-Efficacy as a Dynamic Cognitive Process with the Computational-Unified Learning Model (C-ULM)

Self-efficacy is a person's subjective confidence in their capability of effectively executing behaviors and actions including problem solving. Research has shown it to be one of the most powerful motivators of human action and strongest predictors of performance across a variety of domains. This paper reports on the computational modeling of self-efficacy based on principles derived from the Unified Learning Model (ULM) as instantiated in the multi-agent Computational ULM (C-ULM). The C-ULM simulation is unique in tying self-efficacy directly to the evolution of knowledge itself and in dynamically updating self-efficacy at each step during learning and task attempts. Self-efficacy beliefs have been associated with neural and brain level cognitive processes. Because C-ULM models statistical learning consistent with neural plasticity, the C-ULM simulation provides a model of self-efficacy that is more compatible with neural and brain level instantiation. Results from simulations of self-efficacy evolution due to teaching and learning, task feedback, and knowledge decay are presented. Implications for research into human motivation and learning, cognitive informatics, and cognitive computing are discussed.

Learning Activities that Promote Ability the Proof Groups Using the Internet Network

The purpose of this study is to compare achievement of proof this group with criteria and study of student attitudes toward learning activities using the internet network. The sample is the students who enrolled in the abstract algebra over the academic year 2557, 61 people. The instruments used in research include this plan learning activities using the internet network, achievement tests to prove this group which is subjective confidence 0.82 and the attitude toward plan learning activities using the internet network. The results show that: 1. Students in the learning activities using the internet network to have achievement equal to 70 percent. 2. Students in the learning activities using the internet network to have attitude towards learning activities in the good level

Does aging affect source monitoring and cognitive confidence in schizophrenia? Preliminary results

This study tested the influence of aging on source-monitoring and cognitive confidence deficits in schizophrenia. Younger (n=13) and older (n=10) schizophrenia patients were compared with younger (n=17) and older (n=10) healthy controls in the source-monitoring task. These preliminary results suggest that age negatively influences old/new item recognition, but not source monitoring, in both groups. Age has a negative impact on subjective confidence, but no interaction between group and age was found.

The Sense of Confidence during Probabilistic Learning: A Normative Account

Learning in a stochastic environment consists of estimating a model from a limited amount of noisy data, and is therefore inherently uncertain. However, many classical models reduce the learning process to the updating of parameter estimates and neglect the fact that learning is also frequently accompanied by a variable “feeling of knowing” or confidence. The characteristics and the origin of these subjective confidence estimates thus remain largely unknown. Here we investigate whether, during learning, humans not only infer a model of their environment, but also derive an accurate sense of confidence from their inferences. In our experiment, humans estimated the transition probabilities between two visual or auditory stimuli in a changing environment, and reported their mean estimate and their confidence in this report. To formalize the link between both kinds of estimate and assess their accuracy in comparison to a normative reference, we derive the optimal inference strategy for our task. Our results indicate that subjects accurately track the likelihood that their inferences are correct. Learning and estimating confidence in what has been learned appear to be two intimately related abilities, suggesting that they arise from a single inference process. We show that human performance matches several properties of the optimal probabilistic inference. In particular, subjective confidence is impacted by environmental uncertainty, both at the first level (uncertainty in stimulus occurrence given the inferred stochastic characteristics) and at the second level (uncertainty due to unexpected changes in these stochastic characteristics). Confidence also increases appropriately with the number of observations within stable periods. Our results support the idea that humans possess a quantitative sense of confidence in their inferences about abstract non-sensory parameters of the environment. This ability cannot be reduced to simple heuristics, it seems instead a core property of the learning process.