Discordance Between Perceived and Measured Procedural Competence in Trauma Surgery

OBJECTIVE: The Dunning-Kruger effect is a well-researched influence on the abilities of individuals to accurately estimate their competence in any given domain, such that those with less expertise overestimate their abilities and those with more expertise under estimate their abilities. Dunning Kruger effects among surgeons estimating their procedural competence remains poorly understood. The purpose of this study was to examine the correlation between self-rated and measured procedural competence for 29 trauma procedures in the setting of a cadaver-based laboratory. DESIGN: Each rated their perceived competence to perform each of the procedures before participating in the lab. Each participating surgeon was directly assessed while performing the procedures by expert trauma faculty. SETTING: All work was performed in an operative suite of the cadaver laboratory facilities at our university. PARTICIPANTS: A sample of 452 military general surgeons participated in the study. The professional experience of participants ranged from junior residents to more than 20 years in professional practice. The majority of participants (57%) had less than 5 years of professional experience. RESULTS: Correlational analyses (Kendall tau) demonstrated no significant correlations between the perceived competencies and measured competencies (p < 0.05). CONCLUSIONS: The Dunning-Kruger effect was confirmed with surgeons overestimating their procedural competencies for 28/29 trauma procedures compared to independently assessed procedural performance.