Self-efficacy and its miscalibration in cricothyroidotomy training

• Published in: Human Factors in Healthcare (Online) 2024-06, Vol.5, p.100066, Article 100066
• Main Authors: Etherton, Dr. Kent C., Bliss, Dr. James P., Winner, Ms. Jennifer
• Format: Article
• Language: English
• Subjects: cricothyroidotomy; Dunning-Kruger effect; Overconfidence; Self-efficacy
• ISSN: 2772-5014; 2772-5014
• DOI: 10.1016/j.hfh.2024.100066

Often, trainers use self-assessed competency, or self-efficacy, as a substitute for objective metrics of ability. However, self-efficacy is subject to several cognitive biases like the Dunning-Kruger effect: the tendency for those unskilled at a task to be unaware of their own incompetence (Kruger & Dunning, 1999). We investigated factors that affect self-efficacy and its calibration with performance. This included examining the role of task knowledge when estimating self-efficacy, using recently proposed analyses to assess the Dunning-Kruger effect (Gignac & Zajenkowski, 2020), and examining how indices of such effects may be partially affected by the simulator one trains with. We recruited participants (N = 52) from the local population of a Midwest area in the United States. Using didactic training, a subject matter expert trained participants over a series of trials in a laboratory setting to perform cricothyroidotomy. Results indicated the presence of one, but not both indices of Dunning-Kruger effects (i.e., heteroscedasticity, but not quadratic regression), unique variance in self-efficacy accounted for by task knowledge after controlling for performance, and that the Dunning-Kruger indices were affected by one's training simulator. The current study raised issues relating to the nature of Dunning-Kruger analyses, the importance of task knowledge, and how the analyses conducted in the current study can provide trainers and researchers valuable insights to medical trainees. In sum, our results highlight the value in assessing Dunning-Kruger effects in medical training contexts and provide directions for future research on self-efficacy and its calibration with performance.