Artificial intelligence is increasingly embedded in clinical pathways, making effective human-AI collaboration (HAIC) a practical and policy priority in healthcare. We conducted a scoping review of empirical studies of HAIC in healthcare published from January 2015 to October 2025, using Joanna Briggs Institute methodology and PRISMA-ScR reporting. Of 17,463 records identified, 140 studies were included. Evidence was concentrated in diagnostic interpretation, with fewer studies in screening and triage, therapeutic decision-making, and administrative workflows. Effectiveness was defined inconsistently across task contexts and was usually assessed using short-term task-level metrics rather than patient or system outcomes. Most studies, particularly in diagnostic interpretation, reported benefits for human-AI teams. These depended on task fit, workflow integration, training, and appropriately calibrated trust. Ethical and governance issues, including accountability and patient safety, were often discussed but rarely evaluated empirically. These findings provide a foundation for more task-specific, longitudinal, and governance-aware evaluation of HAIC in healthcare.

OBJECTIVE:Overconfidence is an important source of medical error. This review analyses experimental studies of confidence in medical diagnosis to identify factors affecting clinicians' confidence in their diagnoses and how confidence impacts patient care. METHOD:A scoping review of medical and psychological literature was conducted. Articles were categorised according to methodology and clinical specialty. Findings were analysed thematically. Our review methodology adheres to the JBI's Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. DATA SOURCES:We searched SCOPUS, MEDLINE, PsycINFO and Global Health. We then performed citation tracking within these papers' references to identify additional articles. ELIGIBILITY CRITERIA:Papers were included if they reported quantitative results from an empirical study in which participants reported their confidence or certainty during a diagnostic decision. Studies comprised several medical subdisciplines. RESULTS:77 articles met the inclusion criteria. Across these articles, confidence was not found to be well-calibrated to true diagnostic accuracy regardless of clinician experience. We organised articles under two main themes: the determinants of confidence and the uses of confidence during the patient's care pathway. Confidence is found to be affected by several factors, including case complexity, early diagnostic differentials and the healthcare environment. Factors that affect confidence, but not accuracy, demonstrate how the two can become decoupled, resulting in overconfidence/underconfidence. Confidence is found to affect patient testing, medication administration and referral rates, among other clinical actions. CONCLUSIONS:Improving the calibration of confidence should be a priority for medical education and clinical practice (eg, via decision aids). We propose a theoretical model of factors that affect diagnostic confidence/certainty. Such a model can inform future work on how appropriate diagnostic confidence can be prompted and communicated among clinicians.

Curiosity is a fundamental driver of human cognition and behaviour throughout the lifespan. Distinct from the instrumental value of information in helping to achieve a pre-defined goal, curiosity can be defined as an intrinsic taste for information itself. Although existing research has suggested a role for curiosity in enhancing learning outcomes, questions remain regarding the mechanisms underlying the curiosity-learning relationship. In the current work, we explored the interplay between curiosity, confidence, and learning in relation to the perceived "knowability" of information. Drawing on Loewenstein's information gap theory and the classical observation that curiosity is maximum at intermediate states of knowledge, we propose that curiosity is influenced by the availability of potential answers, reflecting the subjective perception of information's knowability. We conducted two online experiments using trivia questions, wherein participants estimated the number of candidate answers they had in mind for each question, reported their curiosity and confidence regarding the correct answer, and their surprise when told it. Five days later they completed a memory test for those answers. Results indicate that greater availability of candidate answers predicted heightened curiosity, moderate confidence, and enhanced memory retention. These results were replicated in a second experiment despite controlling for prior knowledge. This finding suggests that curiosity is not solely triggered by an information gap but also by the perception that information is retrievable. Our study highlights the significance of subjective perceptions of information accessibility in understanding curiosity and its impact on learning. These findings contribute to the growing body of research investigating the cognitive processes underpinning curiosity and its implications for effective learning strategies.

This perspective considers the contribution of articles in the Journal of Experimental Psychology: Human Perception and Performance to our understanding of mechanisms of control that coordinate component processes of perception and action into an effective task set. Foundations of this research lie in 20th-century debates about whether the fundamental challenge for control arises from capacity limits of serial, discrete processing stages or conflicts between parallel, continuous processes. Fortunes of the field have flourished in the 21st century with detailed studies of adaptive control supporting both flexible task switching and stable task performance in the face of distraction. Future directions are suggested regarding "macro" levels of control. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Uncertainty presents a key challenge when learning how best to act to attain a desired outcome. People can report uncertainty in the form of confidence judgments, but how such judgments contribute to learning and subsequent decisions remains unclear. In a series of three experiments employing an operant learning task, we tested the hypothesis that confidence plays a central role in learning by regulating resource allocation to the seeking and processing of feedback. We predicted that, as participants' confidence in their task knowledge grew, they would discount feedback when it was provided and be correspondingly less willing to pay for it when it was costly. Consistent with these predictions, we found that higher confidence was associated with reduced electrophysiological markers of feedback processing and decreased updating of beliefs following feedback receipt. Bayesian modeling suggests that this decrease in processing was due to a drop in the expected informative value of novel information when participants were highly confident. Thus, when choosing whether to pay a fee to receive further feedback, participants' subjective confidence, rather than the objective accuracy of their decisions, guided their choices. Overall, our results suggest that confidence regulates learning and subsequent decision making.

Understanding the ability to self-evaluate decisions is an active area of research. This research has primarily focused on the neural correlates of self-evaluation during visual tasks and whether neural correlates before or after the primary decision contribute to self-reported confidence. This focus has been useful, yet the reliance on subjective confidence reports may confound our understanding of key everyday features of metacognitive self-evaluation: that decisions must be rapidly evaluated without explicit feedback and unfold in a multisensory world. These considerations led us to hypothesize that an automatic domain-general metacognitive signal may be shared between sensory modalities, which we tested in the present study with multivariate decoding of electroencephalographic (EEG) data. Participants (N = 21,12 female) first performed a visual task with no request for self-evaluations of performance, prior to an auditory task that included rating decision confidence on each trial. A multivariate classifier trained to predict errors in the speeded visual task generalized to distinguish correct and error trials in the subsequent nonspeeded auditory discrimination. This generalization did not occur for classifiers trained on the visual stimulus-locked data and further predicted subjective confidence on the subsequent auditory task. This evidence of overlapping post-response neural activity provides evidence for automatic encoding of confidence independent of any explicit request for metacognitive reports and a shared basis for metacognitive evaluations across sensory modalities.

There is theoretical and practical interest in characterizing the factors that affect the use of advice when making decisions. Here, we investigated how the timing of advice affects its utilization. We conducted three experiments to compare the integration of advice shown before versus after participants had the chance themselves to evaluate evidence relevant to a decision. We used a perceptual discrimination task in a judge–advisor system, allowing careful control over both the participants' task performance and the task structure across conditions except for the timing of advice. Across all experiments, we found that advice provided after stimulus presentation was agreed with more, and influenced participants' judgments to a greater extent, than advice provided beforehand. In Experiment 1, we observed this tendency to hold when advice varied in accuracy and, in Experiment 2, across variations in task difficulty. Experiment 2 also revealed participants' preference for poststimulus advice when they were given choice over when to receive advice. In Experiment 3, we found greater influence of poststimulus advice to hold both for binary judgments and continuous estimations. These results provide interesting implications for research on the mechanisms of advice integration.

When performing tasks in a social context, individuals tend to report confidence judgments that increasingly align with those of others over time. However, the mechanisms underlying this phenomenon, termed confidence matching, are not fully understood. This study explores two potential drivers of confidence matching behavior: informational factors that cause individuals to genuinely recalibrate their private sense of confidence based on their partner's confidence; and normative factors that lead individuals to adapt the way in which they publicly express their confidence, without changing their private assessment of their own performance. To examine these influences, we conducted two experiments examining the effects of both informational and normative factors on private and public confidence. The results demonstrate that both factors can lead to confidence matching. In a setting devoid of feedback, participants matched their confidence reports with their partner's and modified their information-seeking behavior-a proxy for private confidence-accordingly, pointing toward the role of informational factors. Conversely, in a scenario in which feedback was readily available and a joint decision-making rule was enforced, participants aligned their confidence reports with their partner's but did not adjust their information-seeking behavior, hinting at normative factors influencing the public display of confidence matching. These findings highlight the flexibility and context-sensitivity of confidence, thereby underscoring the importance of factoring in social contexts and the adaptive nature of confidence when studying metacognitive processes. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Feedback evaluation can affect behavioural continuation or discontinuation, and is essential for cognitive and motor skill learning. One critical factor that influences feedback evaluation is participants' internal estimation of self-performance. Previous research has shown that two event-related potential components, the FeedbackRelated Negativity (FRN) and the P3, are related to feedback evaluation. In the present study, we used a time estimation task and EEG recordings to test the influence of feedback and performance on participants' decisions, and the sensitivity of the FRN and P3 components to those factors. In the experiment, participants were asked to reproduce the total duration of an intermittently presented visual stimulus. Feedback was given after every response, and participants had then to decide whether to retry the same trial and try to earn reward points, or to move on to the next trial. Results showed that both performance and feedback influenced participants' decision on whether to retry the ongoing trial. In line with previous studies, the FRN showed larger amplitude in response to negative than to positive feedback. Moreover, our results were also in agreement with previous works showing the relationship between the amplitude of the FRN and the size of feedback-related prediction error (PE), and provide further insight in how PE size influences participants' decisions on whether or not to retry a task. Specifically, we found that the larger the FRN, the more likely participants were to base their decision on their performance - choosing to retry the current trial after good performance or to move on to the next trial after poor performance, regardless of the feedback received. Conversely, the smaller the FRN, the more likely participants were to base their decision on the feedback received.

Subjective confidence plays an important role in guiding behaviour, especially when objective feedback is unavailable. Systematic misjudgements in confidence can lead to maladaptive behaviours and have been linked to various psychiatric disorders. This study investigated confidence biases in problem gamblers compared to demographically matched control participants. Confidence was examined across different hierarchical levels of metacognition, encompassing local decision confidence, global task performance confidence, and overarching self-esteem. The problem gamblers demonstrated significantly higher local trial and global task confidence compared to control participants, despite lower self-esteem levels and after controlling for objective task performance. This overconfidence bias persisted even after controlling for the transdiagnostic symptom dimensions Anxiety-Depression and Compulsive Behaviour and Intrusive Thought, on which problem gamblers scored higher compared to control participants. The findings suggest a contrast in problem gamblers between elevated confidence in individual decisions and overall lowered self-esteem. Additionally, the findings indicate that these features cannot be solely attributed to increased Compulsive Behaviour and Intrusive Thought and Anxiety-Depression levels. Factors such as diminished sensitivity to objective evidence, cognitive distortions, and cognitive inflexibility in problem gamblers might fuel overconfidence, thereby triggering the cycle of escalating gambling behaviours.

The optimal way to make decisions in many circumstances is to track the difference in evidence collected in favour of the options. The drift diffusion model (DDM) implements this approach, and provides an excellent account of decisions and response times. However, existing DDM-based models of confidence exhibit certain deficits, and many theories of confidence have used alternative, non-optimal models of decisions. Motivated by the historical success of the DDM, we ask whether simple extensions to this framework might allow it to better account for confidence. Motivated by the idea that the brain will not duplicate representations of evidence, in all model variants decisions and confidence are based on the same evidence accumulation process. We compare the models to benchmark results, and successfully apply 4 qualitative tests concerning the relationships between confidence, evidence, and time, in a new preregistered study. Using computationally cheap expressions to model confidence on a trial-by-trial basis, we find that a subset of model variants also provide a very good to excellent account of precise quantitative effects observed in confidence data. Specifically, our results favour the hypothesis that confidence reflects the strength of accumulated evidence penalised by the time taken to reach the decision (Bayesian readout), with the penalty applied not perfectly calibrated to the specific task context. These results suggest there is no need to abandon the DDM or single accumulator models to successfully account for confidence reports.

Previous research has shown that people are more influenced by advisors who are objectively more accurate, but also by advisors who tend to agree with their own initial opinions. The present experiments extend these ideas to consider people’s choices of who they receive advice from—the process of source selection. Across a series of nine experiments, participants were first exposed to advisors who differed in objective accuracy, the likelihood of agreeing with the participants’ judgments, or both, and then were given choice over who would advise them across a series of decisions. Participants saw these advisors in the context of perceptual decision and general knowledge tasks, sometimes with feedback provided and sometimes without. We found evidence that people can discern accurate from inaccurate advice even in the absence of feedback, but that without feedback they are biased to select advisors who tend to agree with them. When choosing between advisors who are accurate vs. likely to agree with them, participants overwhelmingly choose accurate advisors when feedback is available, but show wide individual differences in preference when feedback is absent. These findings extend previous studies of advice influence to characterise patterns of advisor choice, with implications for how people select information sources and learn accordingly.

Subjective confidence plays an important role in guiding behavior, for example, people typically commit to decisions immediately if high in confidence and seek additional information if not. The present study examines whether people are flexible in their use of confidence, such that the mapping between confidence and behavior is not fixed but can instead vary depending on the specific context. To investigate this proposal, we tested the hypothesis that the seemingly natural relationship between low confidence and requesting advice varies according to whether people know, or do not know, the quality of the advice. Participants made an initial perceptual judgement and then chose between re-sampling evidence or receiving advice from a virtual advisor, before committing to a final decision. The results indicated that, when objective information about advisor reliability was not available, participants selected advice more often when their confidence was high rather than when it was low. This pattern reflects the use of confidence as a feedback proxy to learn about advisor quality: Participants were able to learn about the reliability of advice even in the absence of feedback and subsequently requested more advice from better advisors. In contrast, when participants had prior knowledge about the reliability of advisors, they requested advice more often when their confidence was low, reflecting the use of confidence as a self-monitoring tool signaling that help should be solicited. These findings indicate that people use confidence in a way that is context-dependent and directed towards achieving their current goals.

We introduce a new approach to modelling decision confidence, with the aim of enabling computationally cheap predictions while taking into account, and thereby exploiting, trial-by-trial variability in stochastically fluctuating stimuli. Using the framework of the drift diffusion model of decision making, along with time-dependent thresholds and the idea of a Bayesian confidence readout, we derive expressions for the probability distribution over confidence reports. In line with current models of confidence, the derivations allow for the accumulation of “pipeline” evidence that has been received but not processed by the time of response, the effect of drift rate variability, and metacognitive noise. The expressions are valid for stimuli that change over the course of a trial with normally-distributed fluctuations in the evidence they provide. A number of approximations are made to arrive at the final expressions, and we test all approximations via simulation. The derived expressions contain only a small number of standard functions, and require evaluating only once per trial, making trial-by-trial modelling of confidence data in stochastically fluctuating stimuli tasks more feasible. We conclude by using the expressions to gain insight into the confidence of optimal observers, and empirically observed patterns.

Variability in the detection and discrimination of weak visual stimuli has been linked to oscillatory neural activity. In particular, the amplitude of activity in the alpha-band (8-12 Hz) has been shown to impact the objective likelihood of stimulus detection, as well as measures of subjective visibility, attention, and decision confidence. Here we investigate how preparatory alpha in a cued pretarget interval influences performance and phenomenology, by recording simultaneous subjective measures of attention and confidence (experiment 1) or attention and visibility (experiment 2) on a trial-by-trial basis in a visual detection task. Across both experiments, alpha amplitude was negatively and linearly correlated with the intensity of subjective attention. In contrast with this linear relationship, we observed a quadratic relationship between the strength of alpha oscillations and subjective ratings of confidence and visibility. We find that this same quadratic relationship links alpha amplitude with the strength of stimulus-evoked responses. Visibility and confidence judgments also corresponded with the strength of evoked responses, but confidence, uniquely, incorporated information about attentional state. As such, our findings reveal distinct psychological and neural correlates of metacognitive judgments of attentional state, stimulus visibility, and decision confidence when these judgments are preceded by a cued target interval.

Abstract Introduction Many families now perform specialist medical procedures at home. Families need appropriate training and support to do this. The aim of this study was to evaluate a library of videos, coproduced with parents and healthcare professionals, to support and educate families caring for a child with a gastrostomy. Methods A mixed‐methods online survey evaluating the videos was completed by 43 family carers who care for children with gastrostomies and 33 healthcare professionals (community‐based nurses [n = 16], paediatricians [n = 6], dieticians [n = 6], hospital‐based nurses [n = 4], paediatric surgeon [n = 1]) from the United Kingdom. Participants watched a sample of videos, rated statements on the videos and reflected on how the videos could be best used in practice. Results Both family carers and healthcare professionals perceived the video library as a valuable resource for parents and strongly supported the use of videos in practice. All healthcare professionals and 98% (n = 42) of family carers agreed they would recommend the videos to other families. Family carers found the videos empowering and easy to follow and valued the mixture of healthcare professionals and families featured in the videos. Participants gave clear recommendations for how different video topics should fit within the existing patient pathway. Discussion Families and healthcare professionals perceived the videos to be an extremely useful resource for parents, supporting them practically and emotionally. Similar coproduced educational materials are needed to support families who perform other medical procedures at home. Patient or Public Contribution Two parent representatives attended the research meetings from conception of the project and were involved in the design, conduct and dissemination of the surveys. The videos themselves were coproduced with several different families.

In many domains, imitating others’ behaviour can help individuals to solve problems that would be too difficult or too complex for the individuals. In collective decision making tasks, people have been shown to use confidence as a means to communicate the uncertainty surrounding internal noisy estimates. Here, we show that confidence alignment, namely, shifting average confidence between dyad members towards each other, naturally emerges when interacting with others’ opinions. This alignment has a measurable impact on group performance as well as the accuracy of individual members following information exchange. It is suggested that confidence alignment arises among individuals from the necessity of minimising confidence variation arising from task-unrelated variables (trait confidence), while at the same time maximising variation arising from stimulus characteristics (state confidence).

7 Much work has explored the possibility that the drift diffusion model, a model of response times and choices, could 8 be extended to account for confidence reports. Many methods for making predictions from such models exist, 9 although these methods either assume that stimuli are static over the course of a trial, or are computationally 10 expensive, making it difficult to capitalise on trial-by-trial variability in dynamic stimuli. Using the framework of 11 the drift diffusion model with time-dependent thresholds, and the idea of a Bayesian confidence readout, we derive 12 expressions for the probability distribution over confidence reports. In line with current models of confidence, 13 the derivations allow for the accumulation of “pipeline” evidence which has been received but not processed 14 by the time of response, the effect of drift rate variability, and metacognitive noise. The expressions are valid 15 for stimuli which change over the course of a trial with normally distributed fluctuations in the evidence they 16 provide. A number of approximations are made to arrive at the final expressions, and we test all approximations 17 via simulation. The derived expressions only contain a small number of standard functions, and only require 18 evaluating once per trial, making trial-by-trial modelling of confidence data in dynamic stimuli tasks more feasible. 19 We conclude by using the expressions to gain insight into the confidence of optimal observers, and empirically 20 observed patterns. 21