In Reply The letter by Dr Salles highlights the importance of being incredibly precise about the language that we use to discuss important qualities desired in a surgeon, and I commend her group for doing work that tries to better capture the construct of self-efficacy in surgical trainees instead of the colloquial concept of confidence. I would encourage anyone who does research in this area to be very careful and precise about sharing exactly the definition of whatever social construct they are measuring with the participants of the research. Ensuring that all involved share a common definition of the concept of interest is an important first step, and one that was not clear for many of the confidence studies I reviewed.
Elfenbein DM. Self-Efficacy as a Measure of Confidence—Reply. JAMA Surg. Published online March 08, 2017. doi:10.1001/jamasurg.2017.0044