Twelve tips for developing healthcare learners’ uncertainty tolerance

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Table 1. Twelve tips for supporting healthcare learners’ uncertainty tolerance development are described, alongside suggestions for how these tips may be implemented in practice.

Tip	Implementation Suggestions
Tips for Learners
Tip 1: Understand that uncertainty is inherent to healthcare learning and practice	Consider the reasons underlying uncertainty, e.g. knowledge gaps versus gaps in the body of medical evidence Question the ‘certain’ nature of ‘facts’ by exploring the underlying evidence and identifying where uncertainty is present
Tip 2: Identify factors that influence your uncertainty tolerance	Develop adaptive expertise by gaining a breadth of clinical experience and building conceptual knowledge Collaborate with peers to explore effective and diverse approaches to managing uncertainty
Tip 3: Identify your purposes for managing uncertainty	Identify responsibilities, motivations and values for managing the uncertainty in healthcare practice (e.g. learning to care for patients) Utilise identified purposes to provide a sense of certainty that informs how to manage uncertainty
Tip 4: Critically reflect on uncertain experiences	Use a framework, such as “What? So what? Now what?” to help structure the reflective process Focus on was learnt through uncertain experiences, and how this informs responses to future uncertain scenarios
Tips for Educators and Supervisors Tips
Tip 5: Signpost uncertainty within curricula	Introduce uncertainty relevant to the learner’s stage Highlight research gaps and patient factors that may influence the application of knowledge
Tip 6: Role model uncertainty tolerance	Describe personal experiences of uncertainty similar to those experienced by the learner, and how these were managed Be reassured that expressions of vulnerability can aid learners to appreciate the role of uncertainty tolerance in clinical practice
Tip 7: Support learners across uncertain thresholds	Acknowledge the extent of uncertainty experienced by students at thresholds within curriculum, including uncertainties that may not directly related to intended learning outcomes Reduce extraneous uncertainty through placement orientations and frequent communication
Tip 8: Challenge learners to build their uncertainty tolerance over time	Ask learners to individually communicate knowns and unknowns Increase the authenticity of the educational settings in which uncertainty is experienced (e.g. classroom, followed by simulation, then clinical placements)
Educational Intuitions and Systems Tips
Tip 9: Acknowledge and incorporate uncertainty in assessment strategies	Adopt principles of authentic assessment (e.g. reflective of the uncertainty tolerance required of a health professions graduate) Reward process and reasoning in addition to final ‘answers’
Tip 10: Support near-peer teaching	Train near-peer tutors about pedagogy and uncertainty tolerance Create near-peer mentoring programs that encourage role modelling of uncertainty tolerance
Tip 11: Build institutional uncertainty tolerance	Create a local community of practice focussed on uncertainty tolerance teaching approaches Consider how institutional policies can support educators to introduce uncertainty tolerance teaching approaches, and provide flexibility in policies where possible
Tip 12: Horizontally and vertically integrate approaches to developing uncertainty tolerance	Map existing curricula for sources and moderators of uncertainty Include uncertainty tolerance as a course/degree learning outcome