The Relationship between Diagnostic Accuracy and Confidence in Medical Students.

Studies in psychology and clinical decision making have shown that research subjects and physicians are often overconfident in the accuracy of their judgments. In these studies, groups of 20 first-year and 27 third-year osteopathic medical students at the Ohio University College of Osteopathic Medicine (Athens) were slightly underconfident in their ability to classify artificially-generated abnormal heart rhythms, with good "calibration" at higher confidence levels. Evaluating individuals on "adjusted resolution," which provides an index of the ability to sort correct and incorrect diagnoses into different confidence levels, reveals a curvilinear relationship between diagnostic metacognition (adjusted resolution) and accuracy. The best metacognition was found in subjects achieving 70 to 85 percent diagnostic accuracy. Implications of these findings are discussed. Three figures illustrate the discussion, and an appendix contains a diagram of the decomposition of mean probability scores. (SLD) *********************************************************************** Reproductions supplied by EDRS are the best that can be made from the original document. ***********************************************************************