Why Is It That I Think I Am Better Than You? Antecedents and Consequences of Hospital Employees' Assessment of Their Own Skills Relative to Those of Their Colleagues

Work in health care organizations requires employees to permanently improve their skills, and taking part in continuing education is a prerequisite for keeping a position or for being promoted. Comparing the resulting skills and abilities with those of colleagues and co-workers is a mechanism of status evaluation and, in turn, may produce perceptions of superiority. In a survey of 1050 employees (physicians, nurses, social workers, etc.) from 49 hospitals we asked respondents whether they were worse, equally, or better skilled than the colleagues with whom they work together on a day-to-day-basis. 46 % reported to be better skilled (equally: 50 %, worse: 4 %). This finding is not due to a higher representation of better skilled respondents in the sample and is found in both formally high (e.g. physicians) and low (e.g. nursing assistants) skilled employees, so apparently many respondents overestimate their skills or relate their skills to those of a selective and less skilled subset of the actual comparison group. We try to explain this finding using theories from sociology, social-psychology, and psychology. Estimating multilevel models with individual (level 1) and hospital (level 2) characteristics, we identify antecedents and clustering of employees perceiving to be better skilled than their colleagues. Linking the proportion of these employees in a hospital to its quality of care we attempt to gain insight into the consequences of this phenomenon: Do hospitals do better or worse with higher proportions of employees that rate their skills better than those of their colleagues? We finally discuss whether the high opinion employees have of their own skills may be a result of the permanent self- and third-party evaluation at the workplace and in contemporary societies as a whole.