Dunning Kruger, Imposter Syndrome & Quality Improvement

Dr Victoria Brazil discusses the Dunning-Kruger Effect, Imposter Syndrome and quality improvement. Vic starts the podcast reminiscing about her initial days as a resuscitationist.

She talks about the two psychological phenomena noticed in people working in pre-hospital care. The Dunning-Kruger effect, where people tend to think they are better at a job than they are, and imposter syndrome, where people tend to think they are worse than they are at doing a particular job.

People's perception of their performance can impact their chances of improvement. She suggests scientific methods to reduce this gap in perception. Resuscitation quality improvement (RQI) is a machine-based assessment method to improve the quality of chest compressions that helps doctors and nurses assess and improve their chest compression skills.

An example is a person trying to intubate a patient while wearing a camera. This highlights how different his perception is of what he is doing. According to Vic, an important tool to improvement and reduce the gap in perception is feedback between the person in the field and the consultant. This is because according to Dunning, though we do not assess ourselves correctly, we are good at assessing others.

For the feedback loop to be effective it is essential to follow three basic rules. Firstly, be honest. Secondly, do it often and thirdly be good at extracting feedback. Vic suggests that everyone should start practising giving feedback by assessing speakers. She suggests that rather than giving vague comments like “Good talk mate”, people should make an effort to give speaker specific comments about the talk. This could include what they liked and what could be improved.

Vic demonstrates live feedback of her 47-year-old self giving her younger self, Registrar Vic, some feedback with help from the audience. Through this act she shows how to give effective feedback and how to extract good feedback.

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