• Vasileios Kiosses PgDip, PhD(c) in Medical Education, Medical Education Unit, Department of Hygiene and Epidemiology, Medical Faculty, School of Health Sciences, University of Ioannina, Ioannina, Greece,
  • Claire de Burbure Medical Education Advisor, Faculty of Medicine, Université catholique de Louvain, Brussels, Belgium.
  • Ioannis D K Dimoliatis Associate Professor of Public Health and Medical Education, Medical Education Unit, Department of Hygiene and Epidemiology, Medical Faculty, School of Health Sciences, University of Ioannina, Ioannina, Greece.


Socrates bias, medical education, self-assessment, questionnaire, bias


The objective of the present study was to determine whether bias (over- or under-estimation of self-competence) affects pre-training ratings and hence distorts the actual participation effect of experiential workshops.

Assessments were held during “empathy in doctor-patient relationship” elective courses held during winter 2014, spring 2015 and winter 2016 at Ioannina's Medical School, University of Ioannina, Greece.

Twenty-eight women and 19 men aged 21-28 years (mean = 22.8, SD = 1.52), in 4th (n = 18), 5th (n = 19) and 6th (n=10) year of medical studies took part, voluntarily, in the empathy training.

The Jefferson Scale of Physician Empathy was used on a total of 47 medical undergraduates to measure empathic performance both before (B) and a-posteriori-before (P) training. Overestimation of empathic ability was calculated as the difference B-P, and its significance was checked through paired t-test, while effect size (Cohen’s d) was used to reveal any practical importance.

Participants’ mean B score (+SD) was 110.6 (10.5) whereas P was 88.6 (13.8; p(B-P) < 0.001). Assuming total P as the basis (100), total B was 124.8, i.e 24.8% overestimation. A very large effect size was found (d = 1.81) for B-P indicating a highly practical importance. There were no significant differences between the 3 cohorts nor between men &women.

This study revealed the existence of the “didn't know that they didn’t know” (DNKDNK) bias, offered a simple and easy method to measure it, and estimated it to be 24.8%.


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How to Cite

Vasileios Kiosses, Claire de Burbure, & Ioannis D K Dimoliatis. (2017). “THEY DON’T KNOW THAT THEY DON’T KNOW”: REVEALING AND QUANTIFYING THE SOCRATES BIAS. International Education and Research Journal (IERJ), 3(6). Retrieved from https://ierj.in/journal/index.php/ierj/article/view/1178