Abstract
Introduction: The relationship between confidence and competence in medical students may vary with experience and the situation, but ultimately this relationship will greatly affect patient care and outcomes.
Methods: De-identified self-reported confidence polling data, gender, Medical College Admission Test (MCAT) percentiles, and National Board of Medical Examiners (NBME) exam scores for two course modules (‘Origins’ and ‘Staying Alive’) were analyzed for 117 medical students. Confidence in mastery of course material was rated on a 3-point Likert scale at the beginning and end of each graded session throughout the courses. Associations were analyzed with Mann-Whitney U tests, Wilcoxin signed ranks tests, Spearman rank correlation coefficients, and multiple linear regressions.
Results: Confidence from the beginning to the end of the Origins module dropped significantly for all students. Males demonstrated a decreasing trend in confidence scores throughout the Staying Alive module. Post-session confidence was significantly higher than pre-session confidence in both modules, for all students combined as well as separately for females and males. MCAT percentile was the only significant predictor of NBME exam scores for both modules.
Discussion:There are several considerations for the demonstrated decreasing confidence throughout learning modules, including student burnout. The male-predominant decline in confidence raises interesting questions about gender and resilience, and may reflect unique female experiences in medicine which advance self-confidence. Finally, the lack of correlation between self-assessed confidence and objective performance is interesting, which could be attributed to the Dunning-Kruger effect.