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Does overconfidence coarse through the veins?


Cannulation is the term given to placing a small plastic tube in a vein, in order to deliver medication or fluid. It's regarded as one of the most basic, bread-and-butter procedures for nurses, paramedics, radiographers, doctors - pretty much anyone in a hospital can learn it. However that's not to say it's always easy. I've been a doctor 10 years and am still getting better. The other day I wondered if I was any good. Strangely enough there is no World Championship of Cannulation (would still be less boring than swimming) so it's hard to judge.

The people generally regarded as the cannulation ninjas, anaesthetists, will probably only be asked to do the really hard cases, so even they might not know how good they are as their yardstick is different.

I ran a rigorously scientific Twitter poll to ask people how hot they fancied themselves at the humble skill of cannulation.

The results suggest medics may somewhat overestimate their cannulating expertise. One should expect a normal distribution but this skewed pattern makes sense only to Michael Gove*.

Now I know this was in jest, and the wording of my options may have skewed things, the scale is not linear, it is Twitter not NEJM, there are far too many anaesthetists on Twitter blah blah but I did rather expect these results as cannulation is like sex - no one thinks they're bad at it. In fact the similarities don't stop there. There's talk of a little prick, often quite a bit of poking around, apologies, comments about the lighting, fury, tears and occasionally white fluid and subsequent sleep.

Therefore I don't want to read too much into this but if you're interested in some spin-off reading, check out the Dunning-Kruger effect, where people with a low ability at a given task are unable to recognise how poor they might be and instead overestimate their skill. In many professions, including medicine, it's a dangerous trait to embody. I can live with being average at cannulation. But asking oneself more profound questions such as "am I below average as a doctor/nurse/pilot/scientist?" might provoke the overconfidence bias even more, to avoid the realisation you have a 50% chance of being below average. Whenever I ponder on such topics I console myself with the fact that I'm almost certainly the best dancer in the world.

* Michael Gove is a degenerate nincompoop who, whilst Secretary of State for Education, announced that all schools in the UK should achieve a rating of 'Good', which was only possible if all students exceeded the national average.

#overconfidence #cannulation #learning #DunningKruger #illusorysuperiority

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© Rohin Francis