Exploring Residents' Skills in Diagnosing Dementia: The Unexpected Dissonance Between Ability and Confidence.

BACKGROUND AND OBJECTIVES: The diagnosis of dementia is a challenge for physicians due to numerous interrelated barriers. Research shows that this difficulty may be rooted in an incomplete knowledge about dementia. To address this gap, we developed an assessment scale of resident confidence in the diagnosis of dementia and used it to compare resident confidence to their practical ability to diagnose dementia. METHODS: The study used a piloted confidence assessment tool for diagnosing dementia correlated with family medicine residents (n=45) performance during an objective structured clinical examination (OSCE). Residents were evaluated during the OSCE for thoroughness of evaluation and patient-centeredness. Following the OSCE, they completed knowledge and diagnostic questionnaires and the confidence assessment tool. RESULTS: Residents with more years of training performed a more thorough exam and were more confident in their ability to diagnose dementia. However, residents who missed the diagnosis were no less confident in their ability than residents who correctly diagnosed dementia. CONCLUSIONS: Using confidence as a self-assessment may be an inaccurate representation of resident knowledge and ability to diagnose dementia.