Medical decision-making and confidence in Ghana

Overconfidence among medical decision makers has been linked to diagnostic and treatment errors, which are associated with increased mortality and morbidity in a variety of contexts. While a number of interventions have been tested to directly address overconfidence among medical experts, these interventions have shown only modest success in improving diagnostic quality. Furthermore, we lack a systematic understanding of the prevalence and drivers of overconfidence in low- and middle-income countries (LMICs). Our study aims to fill this gap. We propose to conduct a cross-sectional survey with 1,000 medical decision-makers in Ghana. More specifically our sample will be comprised of medical doctors and physician assistants practicing at GHS health care facilities across Ghana. Further, we include medical students who are enrolled in a medical program in Ghana and who are participating in their 2-year residency training at a teaching hospital. Our study will focus on three aspects: (1) The drivers of overconfidence, discerning between self-image and social image concerns, (2) the real-world implications of overconfidence for patient treatment decisions, and (3) the extent to which existing institutional structures can filter and mitigate the effects of overconfidence on medical decision-making. Through this study, we aim to provide valuable insights that can inform targeted interventions and policy frameworks aimed at mitigating the risks associated with overconfidence in medical practice in LMICs such as Ghana. By understanding the dynamics underlying overconfidence and its consequences, we aim to contribute to improving diagnostic accuracy, treatment effectiveness, and ultimately patient outcomes in these health care contexts.