Public Release: 

Observation articles in Annals of Internal Medicine, March 3, 2015

American College of Physicians

1. Is there a confidence gap between male and female medical students?

Research shows that female medical students are at least as competent as males, yet far less confident

Despite being right at about the same rate or higher as their male counterparts, female medical students answering medical questions on a popular learning platform were significantly less confident about their answers than male participants, according to an Observation article being published in Annals of Internal Medicine.

When it comes to physician competency, confidence matters. Physicians who are overconfident may not ask for help when they need it, and physicians who are under-confident may practice defensive medicine which is more expensive. Research suggests that female medical students perform as well as their male peers but report less confidence in their abilities. Researchers analyzed the question answering behavior of 1,021 male and female users of a web- and mobile-learning platform called Osmosis to compare how their accuracy varied with their confidence. To answer a question in the platform, participants had to select one of three confidence ratings prior to submitting their answer: I'm sure; Feeling lucky; or No clue. The data showed that while women were as accurate as men in their answering behavior they were less confident about their responses.

The authors suggest that insights gained from understanding the relationship between confidence and accuracy could help to improve medical training.

Note: URLs will be live when the embargo lifts. For an embargoed PDF, please contact Megan Hanks. For an interview, please contact the lead author Shiv Gaglani directly at sgaglan1@jhmi.edu.

2. Survey reveals progress and challenges of electronic health record adoption

Under the provisions of the Health Information Technology for Economic Clinical Health (HITECH) Act, physicians are provided substantial economic incentives to implement and use electronic health records (EHRs). The goal is to modernize the information technology infrastructure of the United States health care system. Since passage of the HITECH Act, EHR use has increased steadily, but some reports suggest that a number of physicians do not plan to participate in the program. A two-wave survey of 3,437 U.S. physicians in primary care or related specialties found that by 2013, 63 percent of physicians had an EHR (early adopters) and other 20 percent were in the process of implementing one (partial implementers). The 9 percent that did not plan to implement an EHR (persistent nonadopters) were, on average, older than other physicians and worked in small, isolated practices. These findings suggest that persistent nonadopters may be facing unique challenges that limit their ability to adopt an EHR. These physicians may need support to help them select and implement the systems. Failure to address the needs of these physicians has implications beyond adoption because new models of health care delivery require use of an EHR.

Note: URLs will be live when the embargo lifts. For an embargoed PDF, please contact Megan Hanks. The lead author, Catherine DesRoches, PhD, can be reached directly at cdesroches@mathematica-mpr.com.

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