Self-Assessment and Learning Motivation in the Second Victim Phenomenon

Abstract

Introduction: The experience of a second victim phenomenon after an event plays a significant role in health care providers’ well-being. Untreated; it may lead to severe harm to victims and their families; other patients; hospitals; and society due to impairment or even loss of highly specialised employees. In order to manage the phenomenon, lifelong learning is inevitable but depends on learning motivation to attend training. This motivation may be impaired by overconfidence effects (e.g., over-placement and overestimation) that may suggest no demand for education. The aim of this study was to examine the interdependency of learning motivation and overconfidence concerning second victim effects. Methods: We assessed 176 physicians about overconfidence and learning motivation combined with a knowledge test. The nationwide online study took place in early 2022 and addressed about 3000 German physicians of internal medicine. Statistics included analytical and qualitative methods. Results: Of 176 participants, 83 completed the assessment. Analysis showed the presence of two overconfidence effects and in-group biases (clinical tribalism). None of the effects correlated directly with learning motivation, but cluster analysis revealed three different learning types: highly motivated, competent, and confident “experts”, motivated and overconfident “recruitables”, and unmotivated and overconfident “unawares”. Qualitative analysis revealed four main themes: “environmental factors”, “emotionality”, “violence and death”, and “missing qualifications” contributing to the phenomenon. Discussion: We confirmed the presence of overconfidence in second victim management competencies in about 3% of all persons addressed. Further, we could detect the same three learning motivation patterns compared to preceding studies on learning motivation in other medical competencies like life support and infection control. These findings considering overconfidence effects may be helpful for safety managers, medical teachers, curriculum developers and supervisors to create preventive educational curricula on second victim recognition and management.

Learning motivation and self-assessment in health economics: a survey on overconfidence in healthcare providers

“…This may be due to the small sample size, reduction of the SIMS instrument or motivational factors to participate in the survey. This finding differs from most of our previous studies, except one study on dysphagia management, which also detected only two patterns (‘experts’ and ‘recruitables’ but not ‘unawares’), and one study on second victims 13 that only showed slight differences between the clusters.…”

“… 6 An additional effect is the in-group bias of the clinical tribalism phenomenon (the belief that the own group is superior to other groups). 7 In healthcare, our working group detected these effects in different settings concerning hand hygiene, 8–11 basic life support, 12 second victim management, 13 dysphagiology (under review), and point of care ultrasound (under review). Four of these studies revealed three different types of motivated learners: motivated, confident and competent ‘experts’, motivated but overconfident ‘recruitables’, and amotivated as well as overconfident ‘unawares’.…”

Impact of Flawed Self-Assessment on Learning Motivation in Emergency Point-of- Care Ultrasound

“…We could show a positive correlation between overestimation with extrinsic motivation but not with the other motivational patterns. Compared to previous research [21][22][23], this is the rst time we detected these linear correlations, possibly due to the homogeneity of the sample. Moreover, the different computation models of overplacement and overestimation in the current study as a relative difference between the assessment of one's and other's competencies and the assessment of one's own competencies and the actual test performance might have also contributed to signi cant linear correlations as opposed to our previous studies, in which we calculated overcon dence effects as the absolute differences.…”

Applicability and Validity of Second Victim Assessment Instruments among General Practitioners and Healthcare Assistants (SEVID-IX Study)

“…Our findings of a high symptom count may be valid and comparable to that of Austrian pediatricians [16]. Alternatively, the neglect in self-diagnosis could be attributed to an overconfidence effect in SVP [49] or an unintended violation of one's self-perception. This is comparable to findings in PTSD, where patients may neglect the significance of the disease [50].…”