Physicians' cognitive strategies for avoiding overconfidence

Background: Physicians' overconfidence damages the quality of medical care. Due to their high social status and intense impact on people lives, physicians need to develop strategies to avoid overconfidence. Yet until now, the strategies physicians use to avoid overconfidence have not been explored. This study aimed to identify strategies physicians use to minimize potential overconfidence. Methods: This qualitative study relied on face-to-face semi-structured interviews. Participants were 22 physicians specializing in ophthalmology, gynaecology, rheumatology, cardiology, anaesthesiology, paediatrics, radiology, orthopaedics, otolaryngology, gastroenterology, family and paediatrics. The interviews were analyzed with the grounded theory approach. Results: Analysis of the interviews revealed three prominent strategies physicians use to minimize overconfidence: awareness of the risks of overconfidence, framing a mundane professional identity, and cultivation of a positive self-view through pride based on effort rather than skills. Conclusions: The study demonstrates the on-going nature of establishing physicians' professional identity and implies that it is shaped by a motivation to adapt their identity to fundamental requirements of medical practice. Medical training and education might promote strategies for minimization of potential overconfidence among physicians.