Welcome to REBEL MIND—Mastering Internal Negativity during Difficulty. In this series, we turn the same critical lens REBEL EM uses for literature inward—into mindset, leadership, and psychological safety—so we can deliver better care outward to patients and teams.

In this episode and blog post, host Mark Ramzy and co-host Kim Bambach (Assistant Professor of Emergency Medicine, The Ohio State University) explore a deceptively simple question: How accurately can we assess our own performance? The answer hinges on a classic cognitive bias that touches all of us in emergency medicine.

🗝️Key Points

🧠 We don't know what we don't know: Low experience can inflate confidence; true expertise usually brings humble certainty.

🏥 ED relevance is universal: From central lines to transvenous pacing, over- or under-confidence shows up at every level—intern to seasoned attending.

🧩 Metacognition matters: Accurate self-assessment is a clinical skill; reflection + feedback loops keep us calibrated.

🛠️ Practice beats bravado: Skill decay is real; deliberate practice and HALO (high-acuity, low-occurrence) refreshers protect patients.

🤝 Psychological safety ≠ niceties: "Confident humility" enables questions, feedback, and better resuscitation decisions—especially under uncertainty.

💬Conclusion

The Dunning–Kruger Effect isn't a moral failing; it's a predictable human pattern that every clinician rides—often multiple times per day in the ED. The antidote is metacognition: routine reflection, explicit debiasing, deliberate practice, and feedback within a psychologically safe culture.

🚨Clinical Bottom Line

Competence is quiet and curious. The more we know, the more we recognize what we don't—and the better we become at caring for patients and each other.