Thursday, June 16, 2011

Confidence Curve

I propose that in some jobs there is not only a learning curve, but a confidence curve. And they way the two interrelate can tell you a lot about a person. I guess I've been on a catogorizing high lately-I blame the fact that I'm reading mom's old DSM-IV in my spare time-but here goes.

Type 1: These individuals don't have a confidence curve in the beginning, they have a confidence tower reseambling the Seattle Needle and they are at the very highest point. They may not know much, but they sure think they do! And if they're wrong, it's always someone elses fault. These workers can be extremely frustrating to those who need to train them because some how you have to bring them back to earth a little at a time so they don't screw up so bad and get fired. In the medical field, this is doubly delicate because we're dealing with human life and limb and overconfidence can be detrimental, but underconfidence can be just as bad. Finding a balance is rough. Employee's who at last see a dropping of their confidence line may always be a little unrealistically higher than where their learning curve is, but it is a little more reasonable. It usually takes several major chewing out and mistakes to get them to that point however, and their confidence curve doesn't so much resemble a slope as it does stairs going down as their egos are dropped one small notch at a time.

Type 2: I consider these confidence-learners to be ideal, and I can only think of a few people to whom this might apply. These individuals gain confidence as they learn in tandem. Oh, I mastered that skill? My confidence just went up a notch. They have beautiful sided by side progressions from baseline up to the intended target. Unfortunately, these individuals can-not always, but sometimes-turn into insufferable know-it-alls. I say insufferable because unlike the over confident know-it-alls, these individuals ARE actually always right...because they don't say anything unless they know they are right...and they know they are right because they've learned whatever it is and are confident enough to assert that they're right. See?

Type 3: The underconfident. These individuals are nearly crippled by lack of confidence and with the wrong type of instructor their underconfidence can effect their learning progression. There is no need to worry about over-praising and making these confidence types over confident because their is a constant nagging voice telling them they just don't know enough-aren't smart enough-aren't experienced enough, etc. A little praise can actually go a long way. Their confidence starts slowly rising long after their learning has begun it's climb, in fact you might want to use to different charts to timeline it, because theirs usually a huge gap between the two. If the underconfident don't get a grip on themselves they too end up fired, because underconfidence can lead to major delays in crucial decisions, which isn't good for any business.

Type 4: The Yo-yo. I place myself firmly in this category. I began as an underconfident-learner, almost crippled with fear that whatever decision I'd make would invariably be wrong and bring the world to an end. But as my career has progressed I've had spikes of confidence-sometimes over confidence-and then plummeting back to underconfidence or somewhere in between. My learning curve-I'd like to think-has been pretty steady, and when I can be objective I know I know a heck of a lot more than when I started even if there is still more for me to learn. My spikes in confidence tend to relate to seveal weeks of good patient care, a good "Code" or two, or any other "positive" event at work. The drops tend to relate to the opposite. The issue with the Yo-yo types is they have a hard time keeping proper perspective. Instead of acknowledging "crap happens" and being cautious about the highs as much as the lows, thus allowing a nice steady progression of confidence, their confidence bounces all over the place.

I submit that most people don't belong entirely in one category or the other, we all have ups and downs in confidence, but I also submit that confidence and learning go hand in hand, and keeping an eye on how both progress is a good idea. Also, I'm not going to get into the tangled psychoanalysis of WHY people belong in one category or another, or if the "over confident" are really "extremely insecure" or any of the other underlying psychological conditions. My blog isn't long enough for all of that.

Also, I'm probably on a confidence spike right now because of a recent Cardiac Arrest patient who got a pulse back and I got a successful intubation while in the back of an ambulance going emergency traffic. But thats ok, I'm going to try and enjoy the high while acknowledging realistically that one good cardiac arrest doesn't make me a master....Nope, I'm the bomb. Thats all there is to it. ;)

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