Finding Themselves, Their Place, Their Way: Uncertainties Identified by Medical Students

References

• Lee C, Hall K, Anakin M, Pinnock R. Towards a new understanding of uncertainty in medical education. J Eval Clin Pract. 2021;27(5):1194–1204. doi:10.1111/jep.13503.
   PubMed Web of Science ®Google Scholar
• Strout TD, Hillen M, Gutheil C, et al. Tolerance of uncertainty: a systematic review of health and healthcare-related outcomes. Patient Educ Couns. 2018;101(9):1518–1537. doi:10.1016/j.pec.2018.03.030.
   PubMed Web of Science ®Google Scholar
• Simpkin AL, Khan A, West DC, et al. Stress from uncertainty and resilience among depressed and burned out residents: a cross-sectional study. Acad Pediatr. 2018;18(6):698–704. doi:10.1016/j.acap.2018.03.002.
   PubMed Web of Science ®Google Scholar
• Ghosh AK. Understanding medical uncertainty: a primer for physicians. J Assoc Physicians India. 2004;52:739–742.
   PubMedGoogle Scholar
• Simpkin AL, Schwartzstein RM. Tolerating uncertainty - the next medical revolution? N Engl J Med. 2016;375(18):1713–1715. doi:10.1056/NEJMp1606402.
   PubMed Web of Science ®Google Scholar
• Moffett J, Hammond J, Murphy P, Pawlikowska T. The ubiquity of uncertainty: a scoping review on how undergraduate health professions’ students engage with uncertainty. Adv Health Sci Educ Theory Pract. 2021;26(3):913–958. doi:10.1007/s10459-021-10028-z.
   PubMed Web of Science ®Google Scholar
• Hancock J, Mattick K. Tolerance of ambiguity and psychological well-being in medical training: A systematic review. Med Educ. 2020;54(2):125–137. doi:10.1111/medu.14031.
   PubMed Web of Science ®Google Scholar
• Groot F, Jonker G, Rinia M, ten Cate O, Hoff RG. Simulation at the frontier of the zone of proximal development: a test in acute care for inexperienced learners. Acad Med. 2020;95(7):1098–1105. doi:10.1097/ACM.0000000000003265.
   PubMed Web of Science ®Google Scholar
• Scott A, Sudlow M, Shaw E, Fisher J. Medical education, simulation and uncertainty. Clin Teach. 2020;17(5):497–502. doi:10.1111/tct.13119.
   PubMed Web of Science ®Google Scholar
• Beck JB, Long M, Ryan MS. Into the unknown: helping learners become more comfortable with diagnostic uncertainty. Pediatrics. 2020;146(5):e2020027300. doi:10.1542/peds.2020-027300.
   PubMed Web of Science ®Google Scholar
• Papanagnou D, Ankam N, Ebbott D, Ziring D. Towards a medical school curriculum for uncertainty in clinical practice. Med Educ Online. 2021;26(1):1972762. doi:10.1080/10872981.2021.1972762.
   PubMed Web of Science ®Google Scholar
• White G, Williams S. The certainty of uncertainty: can we teach a constructive response? Med Educ. 2017;51(12):1200–1202. doi:10.1111/medu.13466.
   PubMed Web of Science ®Google Scholar
• Khatri A, Aung YYM, Vijay A, Kazi SUR. Uncertainty in clinical practice: should our focus turn to medical students instead? Med Educ. 2021;55(3):413. doi:10.1111/medu.14375.
   PubMed Web of Science ®Google Scholar
• Stephens GC, Karim MN, Sarkar M, Wilson AB, Lazarus MD. Reliability of uncertainty tolerance scales implemented among physicians and medical students: a systematic review and meta-analysis. Acad Med. 2022;97(9):1413–1422. doi:10.1097/ACM.0000000000004641.
   PubMed Web of Science ®Google Scholar
• Stephens GC, Lazarus MD, Sarkar M, Karim MN, Wilson AB. Identifying validity evidence for uncertainty tolerance scales: A systematic review. Med Educ. 2023;1–13. doi:10.1111/medu.15014.
   Web of Science ®Google Scholar
• Gerrity MS, DeVellis RF, Earp JA. Physicians’ reactions to uncertainty in patient care. A new measure and new insights. Med Care. 1990;28(8):724–736. doi:10.1097/00005650-199008000-00005.
   PubMed Web of Science ®Google Scholar
• Gerrity MS, White KP, DeVellis RF, Dittus RS. Physicians’ reactions to uncertainty: refining the constructs and scales. Motiv Emot. 1995;19(3):175–191. doi:10.1007/BF02250510.
   Web of Science ®Google Scholar
• Geller G, Faden RR, Levine DM. Tolerance for ambiguity among medical students: implications for their selection, training and practice. Soc Sci Med. 1990;31(5):619–624. doi:10.1016/0277-9536(90)90098-d.
   PubMed Web of Science ®Google Scholar
• Hancock J, Roberts M, Monrouxe L, Mattick K. Medical student and junior doctors’ tolerance of ambiguity: development of a new scale. Adv Health Sci Educ Theory Pract. 2015;20(1):113–130. doi:10.1007/s10459-014-9510-z.
   PubMed Web of Science ®Google Scholar
• Budner SNY. Intolerance of ambiguity as a personality variable. J Pers. 1962;30(1):29–50. doi:10.1111/j.1467-6494.1962.tb02303.x.
   PubMed Web of Science ®Google Scholar
• Caulfield M, Andolsek K, Grbic D, Roskovensky L. Ambiguity tolerance of students matriculating to U.S. medical schools. Acad Med. 2014;89(11):1526–1532. doi:10.1097/acm.0000000000000485.
   PubMed Web of Science ®Google Scholar
• Morton KR, Worthley JS, Nitch SR, Lamberton HH, Loo LK, Testerman JK. Integration of cognition and emotion: a postformal operations model of physician-patient interaction. J Adult Dev. 2000;7(3):151–160. doi:10.1023/A:1009542229631.
   Web of Science ®Google Scholar
• van Ryn M, Hardeman RR, Phelan SM, et al. Psychosocial predictors of attitudes toward physician empathy in clinical encounters among 4732 1st year medical students: a report from the changes study. Patient Educ Couns. 2014;96(3):367–375. doi:10.1016/j.pec.2014.06.009.
   PubMed Web of Science ®Google Scholar
• Lally J, Cantillon P. Uncertainty and ambiguity and their association with psychological distress in medical students. Acad Psychiatry. 2014;38(3):339–344. doi:10.1007/s40596-014-0100-4.
   PubMed Web of Science ®Google Scholar
• Reis-Dennis S, Gerrity MS, Geller G. Tolerance for uncertainty and professional development: a normative analysis. J Gen Intern Med. 2021;36(8):2408–2413. doi:10.1007/s11606-020-06538-y.
   PubMed Web of Science ®Google Scholar
• Blanch DC, Hall JA, Roter DL, Frankel RM. Is it good to express uncertainty to a patient? correlates and consequences for medical students in a standardized patient visit. Patient Educ Couns. 2009;76(3):300–306. doi:10.1016/j.pec.2009.06.002.
   PubMed Web of Science ®Google Scholar
• Fox RC. Training for uncertainty. In: Merton RK, Reader GG, eds. The Student-Physician: Introductory Studies in the Sociology of Medical Education. Cambridge, MA: Harvard University Press; 1957:207–242.
   Google Scholar
• Lingard L, Garwood K, Schryer CF, Spafford MM. A certain art of uncertainty: case presentation and the development of professional identity. Soc Sci Med. 2003;56(3):603–616. doi:10.1016/S0277-9536(02)00057-6.
   PubMed Web of Science ®Google Scholar
• Holmes SM, Ponte M. En-case-ing the patient: disciplining uncertainty in medical student patient presentations. Cult Med Psychiatry. 2011;35(2):163–182. doi:10.1007/s11013-011-9213-3.
   PubMed Web of Science ®Google Scholar
• Weurlander M, Lönn A, Seeberger A, Hult H, Thornberg R, Wernerson A. Emotional challenges of medical students generate feelings of uncertainty. Med Educ. 2019;53(10):1037–1048. doi:10.1111/medu.13934.
   PubMed Web of Science ®Google Scholar
• Wolpaw T, Cote L, Papp KK, Bordage G. Student uncertainties drive teaching during case presentations: more so with SNAPPS. Acad Med. 2012;87(9):1210–1217. doi:10.1097/ACM.0b013e3182628fa4.
   PubMed Web of Science ®Google Scholar
• Nevalainen MK, Mantyranta T, Pitkala KH. Facing uncertainty as a medical student–a qualitative study of their reflective learning diaries and writings on specific themes during the first clinical year. Patient Educ Couns. 2010;78(2):218–223. doi:10.1016/j.pec.2009.07.011.
   PubMed Web of Science ®Google Scholar
• Gowda D, Dubroff R, Willieme A, Swan-Sein A, Capello C. Art as sanctuary: a four-year mixed-methods evaluation of a visual art course addressing uncertainty through reflection. Acad Med. 2018;93(11S Association of American Medical Colleges Learn Serve Lead: Proceedings of the 57th Annual Research in Medical Education Sessions):S8–S13. doi:10.1097/acm.0000000000002379.
   PubMedGoogle Scholar
• Park S. Embracing uncertainty within medical education. In: Giardino AP, Giardino ER, eds. Medical Education: Global Perspectives, Challenges and Future Directions. New York: Nova Science Publishers Inc; 2013:289–313.
   Google Scholar
• Stephens GC, Rees CE, Lazarus MD. Exploring the impact of education on preclinical medical students’ tolerance of uncertainty: a qualitative longitudinal study. Adv Health Sci Educ Theory Pract. 2021;26(1):53–77. doi:10.1007/s10459-020-09971-0.
   PubMed Web of Science ®Google Scholar
• Stephens GC, Sarkar M, Lazarus MD. ‘A whole lot of uncertainty’: A qualitative study exploring clinical medical students’ experiences of uncertainty stimuli. Med Educ. 2022;56(7):736–746. doi:10.1111/medu.14743.
   PubMed Web of Science ®Google Scholar
• Russel SM, Geraghty JR, Renaldy H, Thompson TM, Hirshfield LE. Training for professional uncertainty: socialization of medical students through the residency application process. Acad Med. 2021;96(11S):S144–S150. doi:10.1097/ACM.0000000000004303.
   PubMed Web of Science ®Google Scholar
• Terry G, Braun V. Short but often sweet: the surprising potential of qualitative survey methods. In: Gray D, Clarke V, Braun V, eds. Collecting Qualitative Data: A Practical Guide to Textual, Media and Virtual Techniques. Cambridge: Cambridge University Press; 2017:13–14. doi:10.1017/9781107295094.003.
   Google Scholar
• Crotty M. Interpretivism: for and against culture. In Foundations of Social Research. London: Routledge; 1998:66–78.
   Google Scholar
• Braun V, Clarke V, Gray D. Innovations in qualitative methods. In: Gough B, ed. The Palgrave Handbook of Critical Social Psychology. Palgrave. New York: Macmillan; 2017:243–266. doi:10.1057/978-1-137-51018-1_13.
   Google Scholar
• Tremblay D, Turcotte A, Touati N, et al. Development and use of research vignettes to collect qualitative data from healthcare professionals: a scoping review. BMJ Open. 2022;12(1):e057095. doi:10.1136/bmjopen-2021-057095.
   PubMed Web of Science ®Google Scholar
• Braun V, Clarke V, Hayfield N, Terry G. Thematic analysis. In: Liamputtong P, ed. Handbook of Research Methods in Health Social Sciences. Singapore: Springer Singapore; 2018:1–18. doi:10.1007/978-981-10-2779-6_103-1.
   Google Scholar
• Mann K, MacLeod A. Constructivism: learning theories and approaches to research. In Researching Medical Education. Chichester, UK: John Wiley & Sons, Ltd; 2015:49–66. doi:10.1002/9781118838983.ch6.
   Google Scholar
• Henning K, Ey S, Shaw D. Perfectionism, the impostor phenomenon and psychological adjustment in medical, dental, nursing and pharmacy students. Med Educ. 1998;32(5):456–464. doi:10.1046/j.1365-2923.1998.00234.x.
   PubMed Web of Science ®Google Scholar
• Gottlieb M, Chung A, Battaglioli N, Sebok-Syer SS, Kalantari A. Impostor syndrome among physicians and physicians in training: a scoping review. Med Educ. 2020;54(2):116–124. doi:10.1111/medu.13956.
   PubMed Web of Science ®Google Scholar
• Hafferty FW. Beyond curriculum reform: confronting medicine’s hidden curriculum. Acad Med. 1998;73(4):403–407. doi:10.1097/00001888-199804000-00013.
   PubMed Web of Science ®Google Scholar
• Lawrence C, Mhlaba T, Stewart KA, Moletsane R, Gaede B, Moshabela M. The hidden curricula of medical education: a scoping review. Acad Med. 2018;93(4):648–656. doi:10.1097/ACM.0000000000002004.
   PubMed Web of Science ®Google Scholar
• Torralba KD, Jose D, Byrne J. Psychological safety, the hidden curriculum, and ambiguity in medicine. Clin Rheumatol. 2020;39(3):667–671. doi:10.1007/s10067-019-04889-4.
   PubMed Web of Science ®Google Scholar
• Gaufberg EH, Batalden M, Sands R, Bell SK. The hidden curriculum: what can we learn from third-year medical student narrative reflections? Acad Med. 2010;85(11):1709–1716. doi:10.1097/ACM.0b013e3181f57899.
   PubMed Web of Science ®Google Scholar
• LaDonna KA, Ginsburg S, Watling C. “Rising to the level of your incompetence”: what physicians’ self-assessment of their performance reveals about the imposter syndrome in medicine. Acad Med. 2018;93(5):763–768. doi:10.1097/ACM.0000000000002046.
   PubMed Web of Science ®Google Scholar
• Molloy E, Bearman M. Embracing the tension between vulnerability and credibility: ‘intellectual candour’ in health professions education. Med Educ. 2019;53(1):32–41. doi:10.1111/medu.13649.
   PubMed Web of Science ®Google Scholar
• Ilgen JS, Eva KW, de Bruin A, Cook DA, Regehr G. Comfort with uncertainty: reframing our conceptions of how clinicians navigate complex clinical situations. Adv Health Sci Educ Theory Pract. 2019;24(4):797–809. doi:10.1007/s10459-018-9859-5.
   PubMed Web of Science ®Google Scholar
• Han PKJ, Strout TD, Gutheil C, et al. How physicians manage medical uncertainty: a qualitative study and conceptual taxonomy. Med Decis Making. 2021;41(3):275–291. doi:10.1177/0272989X21992340.
   PubMed Web of Science ®Google Scholar
• LaDonna KA, Taylor T, Lingard L. Why open-ended survey questions are unlikely to support rigorous qualitative insights. Acad Med. 2018;93(3):347–349. doi:10.1097/acm.0000000000002088.
   PubMed Web of Science ®Google Scholar
• Tversky A, Kahneman D. Judgment under uncertainty: Heuristics and biases. Science. 1974;185(4157):1124–1131. doi:10.1126/science.185.4157.1124.
   PubMed Web of Science ®Google Scholar