To the editor: Dr. Kadhim-Saleh and colleagues have likely demonstrated the Dunning-Kruger effect among emergency physicians.Reference Kadhim-Saleh, Worrall, Taljaard, Gatien and Perry 1 The Dunning-Kruger effect is the observation that individuals with reduced skills in a domain also have reduced metacognitive ability to be aware that their skills are reduced.Reference Kruger and Dunning 2
It is important to label the effect when found in order to facilitate discussion and linkage of studies across domains. The Dunning-Kruger effect has been repeatedly demonstrated in domains ranging from the original studies in logical reasoning and writing abilityReference Kruger and Dunning 2 to more recent studies of variability in leadership skills.Reference Sheldon, Dunning and Ames 3 , Reference Giambatista and Hoover 4 The effect has been found in a systematic review of physician skills.Reference Davis, Mazmanian, Fordis, Van Harrison, Thorpe and Perrier 5
The pervasiveness of the Dunning-Kruger effect and its ability to reduce the quality of health care directly through suboptimal medical decisions and indirectly through suboptimal medical leadership mandates further research. Regarding mitigation of the Dunning-Kruger effect, initial studies show that persons who are unaware of their deficits are also less ableReference Kruger and Dunning 2 and less willingReference Giambatista and Hoover 4 to take advantage of feedback and benchmarking.
To be certain that the authors have found the Dunning-Kruger effect, the analysis and plot should be slightly different as estimated in Figure 1 and done in the original studies by Dunning and Kruger.
Figure 1 Simulation of Dunning-Kruger effect.
