Ambiguity Tolerance and Prospective Specialty Choice Among Third-Year Medical Students

Бабенко, Оксана; Linkiewich, Delane; Lodewyk, Kalee; Lee, Ann

doi:10.22454/primer.2021.453158

Cited by 3 publications

(1 citation statement)

References 9 publications

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“…It was well validated through psychometric analyses of survey data from approximately 500 medical students and postgraduate trainees, consequently forming a 29-item scale. Since the TAMSAD scale is the only tool that specifically assesses TOA in clinical situations, it has been widely used for medical education research in Western countries [ 2 , 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Translation, adaptation, and validation of the Tolerance of Ambiguity in Medical Students and Doctors (TAMSAD) scale for use in Japan

et al. 2023

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Background Ambiguity is inherent to the medical field; hence, assessing and educating medical trainees regarding ambiguity tolerance is essential. The Tolerance of Ambiguity in Medical Students and Doctors (TAMSAD) scale—a novel instrument that assesses ambiguity tolerance in clinical settings—has been widely used for medical education research in Western countries. However, a version of this scale applicable to the intricate clinical contexts of Japan has not yet been developed. In this study, we developed the Japanese version of the TAMSAD (J-TAMSAD) scale and tested its psychometric properties. Methods In this multicenter study, we collected data through a cross-sectional survey in two universities (medical students) and ten hospitals (residents) across Japan, and evaluated the structural validity, criterion-related validity, and internal consistency reliability of the J-TAMSAD scale. Results We analyzed the data of 247 participants. The sample was randomly divided in half, with exploratory factor analysis (EFA) performed on one half and confirmatory factor analysis (CFA) on the other. EFA led to an 18-item J-TAMSAD scale comprising five factors. CFA showed acceptable fit for this five-factor model (comparative fit index = 0.900, root mean square error of approximation = 0.050, standardized root mean square residual = 0.069, goodness of fit index = 0.987). There was a positive correlation between the J-TAMSAD scale scores and total reverse scores on the Japanese version of the Short Intolerance of Uncertainty Scale (Pearson correlation coefficient 0.41). The internal consistency was found to be satisfactory (Cronbach’s alpha 0.70). Conclusions The J-TAMSAD scale was developed, and its psychometric properties were confirmed. The instrument can be useful for assessing tolerance of ambiguity among medical trainees in Japan. With further validation, it could be used to verify the educational effectiveness of curricula that foster ambiguity tolerance in medical trainees, or even in research assessing the relationship with other variables.

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Section: Introductionmentioning

confidence: 99%

Translation, adaptation, and validation of the Tolerance of Ambiguity in Medical Students and Doctors (TAMSAD) scale for use in Japan

et al. 2023

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Re-evaluating the factor structure of the Tolerance of Ambiguity of Medical Students And Doctors (TAMSAD) scale in newly qualified doctors

Hancock,

Ukoumunne,

Mattick

et al. 2024

MedEdPublish

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Background Ambiguity and uncertainty are inherent within the practice of medicine. While theory suggests the construct may be multidimensional, scales such as the Tolerance of Ambiguity of Medical Students And Doctors (TAMSAD) act unidimensionally, at least in a local population. Therefore, the dimensionality of the Tolerance of Ambiguity (ToA) construct remains unclear. This study aims to explore the dimensionality of ToA in early postgraduate doctors using the TAMSAD scale in a UK national sample and consider the implications of this dimensionality for theory and practice. Methods We used data from 428 respondents in a national research project examining the experiences of newly qualified doctors in the UK (2020). We undertook an exploratory factor analysis (extracting one-factor to six-factor solutions) of the 29-item TAMSAD scale and compared findings to an existing integrative model of uncertainty tolerance. Results The analysis suggested that the ToA construct is multidimensional. The three-factor model and five-factor model provided clinically interpretable factors and had different merits. It appears that having an affinity for complexity is not simply the opposite of experiencing discomfort from uncertainty, and that a professional’s epistemological beliefs about the nature of medicine may influence their ToA. Conclusions These findings support an extension to a key integrative model of uncertainty tolerance, and support development of interventions to increase ToA in doctors. For example, through encouraging increased reflection on an individual’s own epistemological beliefs about medicine and the role of doctors. The potential impact of such interventions can be evaluated using scales such as the TAMSAD.

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Evaluation and Comparison of Tolerance of Ambiguity in Veterinary Pathology Professionals and Trainees

Fernandez,

Dickinson,

Burgess

et al. 2024

Journal of Veterinary Medical Education

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Ambiguity is ubiquitous in veterinary medicine, including in clinical and anatomic pathology. Tolerance of ambiguity (TOA) relates to how individuals navigate uncertainty. It is associated with psychological well-being in health professionals yet has been little investigated in veterinarians or veterinary pathologists. In this study, we used the Tolerance of Ambiguity of Veterinary Students (TAVS) scale and eight previously evaluated items specific to clinical pathology to evaluate and compare TOA in pathology professionals and trainees. We hypothesized that scores would be higher (reflecting greater TOA) for professionals than for trainees, that scores would increase with years of diagnostic experience for professionals and year of study for trainees, and that scores would be higher for clinical than anatomic pathologists due to the frequent ambiguity of clinical pathology practice. One hundred eighty one pathology professionals and trainees participated. TAVS scores were significantly higher for professionals than for trainees, and scores increased significantly with year of experience for professionals but not with year of study for trainees. When comparing disciplines, TAVS scores for all clinical pathologists were significantly lower than scores for all anatomic pathologists. Scores for clinical pathology specific items showed similar trends to TAVS scores, except when comparing disciplines (clinical pathologists tended to have higher scores for these items). Results suggest pathology professionals become more tolerant of ambiguity throughout their careers, independent of increasing TOA with age, and that navigating ambiguity might be more difficult for trainees than for professionals. Educational interventions might help trainees learn to successfully navigate ambiguity, which could impact psychological well-being.

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Ambiguity Tolerance and Prospective Specialty Choice Among Third-Year Medical Students

Cited by 3 publications

References 9 publications

Translation, adaptation, and validation of the Tolerance of Ambiguity in Medical Students and Doctors (TAMSAD) scale for use in Japan

Translation, adaptation, and validation of the Tolerance of Ambiguity in Medical Students and Doctors (TAMSAD) scale for use in Japan

Re-evaluating the factor structure of the Tolerance of Ambiguity of Medical Students And Doctors (TAMSAD) scale in newly qualified doctors

Evaluation and Comparison of Tolerance of Ambiguity in Veterinary Pathology Professionals and Trainees

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