The Overconfident Misperceptions and Complacent Inactions framework has a lot to say about optimizing healthcare communication and education programs.
I was invited to talk about our framework for the “Legends Series” on the podcast of the Alliance for Continuing Education in the Health Professions, hosted by Brian McGowan of ArcheMedX.
After discussing my academic background and intellectual evolution, Brian and I talked about what complacent inaction and overconfident misperceptions are, and how to overcome the barriers they create for behavior change.
During our talk, Brian described complacent inaction as “knowing doesn’t equal doing.” We agree. There are many things people know they should change, but don’t. Like many people, I know I should eat more vegetables, but I don’t always manage to. In healthcare, many people know they should but fail to a) adhere to medications, b) adopt new technologies, c) improve their skill sets, etc. Change is hard, even when we know we should do it.
As I often do, I quoted Nobel Laureate Richard Thaler: “If you want someone to change, make it easy for them to do so.” The problem is, it’s usually quite difficult to make things easy for people. So I was excited to talk a little about my friend (and Wharton professor) Katy Milkman’s new book, How to Change. I think it’s a great resource for anyone working in healthcare. She breaks down seven psychological barriers that stop people from engaging in behavior change and she has a chapter describing how to make it a little easier to overcome each of those barriers. Alas, there is no silver bullet, but there are dozens of actionable things we can do to make it easier for ourselves and others to make the right choice at the right time.
Often, we don’t know we have to change. This is the problem of “Overconfident Misperception”. Decades of research show that people tend to be overly certain that their perceptions match reality. Importantly, this is not the same as arrogance. Someone can be overly certain that they’re going to fail or that they’re not as good as someone else (and they might be wrong about that). Overconfident misperceptions are simply having too strong of a belief in our perceptions.
In the podcast, Brian and I talk a little about the case of metabolism. Ask most people and they’d tell you that some people have faster metabolisms than others or that you can somehow “boost” metabolism. Yet even biochemists don’t fully understand all the details of how metabolism works. The idea of “boosting metabolism” is scientifically vague, at best. But because the idea of a metabolism booster is familiar (from marketing claims) and because we eat and metabolize all day long, we feel that we know more about metabolism than we do. Such “illusions of knowledge” are rampant in healthcare.
Brian and I talk about how thoughtful question asking is one of the best ways to push back against overconfident misperceptions or illusions of knowledge. Some questions I like are variations of: “How does that work?” and “How sure are you?” The point is to help people start to recognize holes in their thinking. Only then will they be open to learning something new.