A Pattern We Have Never Seen: An Extraordinary Amount of Uncertainty

Amplifire has measured certainty through nearly a billion learner interactions over the last decade. What we’ve never seen before is high uncertainty among clinicians. Usually, doctors are confident in what they think they know, but in our latest sepsis pilot, doctors had high levels of uncertainty regarding new information about sepsis.

The sepsis course was designed around the latest evidence-based data, practices, and bundles in recognizing and treating sepsis. The doctors perceived correctly that this was new information for them and were honest about their uncertainty.

Human beings are predisposed to overconfidence because it’s an adaptive feature that was forged in human psychology. Confidence is an attractive trait that has led to survival and success for those who display it proudly, even when that confidence is sometimes misplaced. It is difficult for most professionals to acknowledge their uncertainty, even when it is warranted. Not so with these docs.

Visualizing Clinician Variation

Doctors need the freedom to exercise their decision-making powers in the face of human complexity. However, doctors should not be making decisions based on out-of-date information. Old information that gets welded into memory in medical school is hard to identify and harder to eliminate. Continuing medical education has no ability to identify this confidently held misinformation (CHM), much less eliminate it.

The wide range of doctor experience since medical school is what we are seeing when we look at the variation among doctors seen below. The graph shows the range of confidence and accuracy for three doctors pulled from the best, average, and worst ends of the heatmap.