Abstract / Summary
Abstract Background Kidney stones are common in Saudi Arabia. The two main types are handled differently: calcium oxalate (CaOx) stones resist pharmacological dissolution, whereas uric acid (UA) stones can be broken down by alkalinising the urine. Junior clinicians are usually the first to image and triage these patients, yet they may read their own competence inaccurately. Whether such a mismatch exists in Saudi trainees has not, as far as we know, been examined. Methods Using a bilingual Arabic-English electronic questionnaire, this cross-sectional survey set the factual knowledge of 407 Riyadh-based participants against their self-perceived knowledge; the sample comprised clinical-year medical students, interns, and general practitioners. Four factual items (rescaled to 0–10) and thirteen self-perceived Likert items (Cronbach’s α = 0.834) were sorted by modified Bloom’s thresholds, and the difference between the two, self-perceived minus factual, was taken to index calibration. Analysis drew on Kruskal-Wallis tests and Spearman correlation, together with multivariable regression. Results Good factual knowledge proved far more common than a Good self-rating (41.3% vs 6.6%). Self-perception tracked actual performance only loosely (Spearman ρ = 0.224, p < .001), and the sample underrated itself (mean knowledge gap − 1.41). Medical students were strongest on the factual items but carried the largest negative gap (− 1.92), while general practitioners scored lowest (p = .018). Accuracy reached 82.8% for uric acid dissolvability and 88.4% for CT stone density, yet fell to 42.1% for CaOx non-dissolvability. After adjustment, the 34–40 age band predicted weaker factual knowledge (β = −3.63, p < .001), whereas it was cadre that predicted calibration, with interns and general practitioners less under-confident than students (p = .003 and .027). Conclusions For junior clinicians, the main shortfall in stone knowledge seems to lie less in missing facts than in poor calibration and under-confidence, a problem that worsens as knowledge fades after training. Education built around cases and rich in feedback, sustained past graduation and working on factual grasp and on confidence calibration at the same time, might sharpen stone-related decisions and narrow the scope for avoidable error in how patients are counselled and cared for.