Intended for healthcare professionals

Rapid response to:

Analysis

Errors in clinical reasoning: causes and remedial strategies

BMJ 2009; 338 doi: https://doi.org/10.1136/bmj.b1860 (Published 08 June 2009) Cite this as: BMJ 2009;338:b1860

Rapid Response:

And then there is the Dunning-Kruger Effect.

In their wonderful work which won them the Ig Noble Prize (1); D
Dunning and J Kruger looked at the how people's lack of competence at a
particular task or skill not only causes them to reach wrong conclusions,
but also renders them oblivious to realise the mistake. While the first
part is a cognitive ability, the second has been described as a
metacognitive capacity - the monitoring of one's own performance.

They have described how incompetence (metacognitive defects) lead to
dramatic over-estimation of one's own abilities and performance, and an
inflated self-assessment. And how such people are also less able to
recognise and rate genuine levels of competence accurately in either
themselves or in (objectively) more competent peers. Such people will also
find it harder to gain insight into their limitations and inadequacies by
social comparison i.e. an inability to 'see' their own deficits (and
fruitful self-analysis) in relation to their peers performance.

However, such metacognitive deficits can be improved, and skills (and
insight) gained by actually gaining competence at the particular task or
skill in question.

Dunning and Kruger have gone further to discuss this effect (defect)
as a psychological analogue to anososgnosia; attesting Charles Darwin
(1871) "ignorance more frequently begets confidence than does
knowledge"...

....harsh, sad, fact!

Reference:
(1) Kruger J and Dunning D. Unskilled and Unaware of It: How Difficulties
In Recognising One's Own Incompetence Lead to Inflated Self-Assessments.
Journal of Personality and Social Psychology 1999, Vol. 77, No. 6, 1121-
1134

weblink pdf:
http://www.apa.org/journals/features/psp7761121.pdf

Competing interests:
None declared

Competing interests: No competing interests

09 July 2009
Arnob Chakraborti
Registrar (ST4) General Adult Psychiatry
Ida Darwin, Fulbourn, Cambridge CB21 5EE
CAMEO (Cambridge Early Intervention services)