Medical Uncertainty in Students Entering Medical School

Sobal, Jeffery; DeForge, Bruce R.

doi:10.1080/00380237.1991.10570596

Cited by 4 publications

(11 citation statements)

References 25 publications

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“…Weissenstein, Ligges, Brouwer, Marschall, and Friederichs found females were slightly more tolerant of social conflicts and insoluble problems, while males were more open to new experiences 44 . No significant differences in views of uncertainty or ambiguity tolerance were found among students in different years of medical school or between physicians and medical students, 41 , 43 , 44 but in one study, first-year family practice residents were found to be less tolerant of ambiguity than residents in their second and third years 42 . While no difference in ambiguity tolerance was found between community-based and university-based residents, 42 dual degree MD/MBA students were found to have higher tolerance of ambiguity than traditional medical students 40 .…”

Section: Resultsmentioning

confidence: 93%

“…Contextual factors of the clinical or educational environment or of individual patient cases, such as severity of an illness, risk involved in decision-making, and the patient’s desire for certainty are thought to influence physicians’ reactions to uncertainty and perception of “gut feelings,” implicit knowledge characterized by feelings of alarm or reassurance 22 , 28 . Also, socialization through pre-medical coursework and public media may influence entering medical students to be more aware of uncertainty in medicine 41 . Conversely, reliance on technology and the fast pace of scientific knowledge development may foster desire for structure, intolerance of ambiguity, and views of knowledge as certain 25 , 44 .…”

Section: Resultsmentioning

confidence: 99%

“…Longitudinal studies could show more conclusively how epistemic cognition changes over time and in different phases of education and practice 30 , 31 , 41 , 42 43 .…”

Section: Resultsmentioning

confidence: 99%

“…Developing new, psychometrically valid instruments could allow researchers to more accurately study epistemological phenomena, such as the ability to discriminate between tolerance of ambiguity and uncertainty 43 . Mixed-methods studies could build upon and scale up qualitative work on reactions to uncertainty, 35 and ethnographic and narrative methods could better elucidate nuances of epistemic cognition as enacted in naturalistic settings 25 , 27 , 41 . Additionally, multidisciplinary research may be useful to examine internal and external factors from different perspectives 31 …”

Section: Resultsmentioning

confidence: 99%

“…Some call for research on whether epistemic cognition can be changed through education, 41 , 43 , 44 and several cite the need for research on the relationships among education on epistemology, physician behavior, and clinical outcomes 22 , 27 , 31 , 36 , 43 …”

Section: Resultsmentioning

confidence: 99%

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Epistemic cognition in medical education: a literature review

Eastwood¹,

Koppelman-White

et al. 2017

Int J Med Educ

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ObjectiveTo review the research literature on epistemic cognition in medical education.MethodsWe conducted database searches using keywords related to epistemic cognition and medical education or practice. In duplicate, authors selected and reviewed empirical studies with a central focus on epistemic cognition and participant samples including medical students or physicians. Independent thematic analysis and consensus procedures were used to identify major findings about epistemic cognition and implications for research and medical education. ResultsTwenty-seven articles were selected. Themes from the findings of selected studies included developmental frameworks of epistemic cognition revealing simple epistemological positions of medical learners, increasing epistemological sophistication with experience, relationships between epistemic cognition and context, patterns in epistemic orientations to clinical practice, and reactions to ambiguity and uncertainty. Many studies identified the need for new instruments and methodologies to study epistemic cognition in medical education settings and its relationship to clinical outcomes. Relationships between epistemological beliefs and humanistic patient care and influences of medical education practices were commonly cited implications for medical education. ConclusionsEpistemic cognition is conceptualized and operationalized in a variety of ways in the medical research literature. Advancing theoretical frameworks and developing new methodological approaches to examine epistemic cognition are important areas for future research. Also, examination of the relationship between the contexts of medical learning and practice and epistemic cognition has potential for improving medical education. This work also establishes a need for further investigation into the implications of epistemic cognition for humanistic orientations and ultimately for patient care.

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Section: Resultsmentioning

confidence: 93%

Section: Resultsmentioning

confidence: 99%

“…Longitudinal studies could show more conclusively how epistemic cognition changes over time and in different phases of education and practice 30 , 31 , 41 , 42 43 .…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Epistemic cognition in medical education: a literature review

Eastwood¹,

Koppelman-White

et al. 2017

Int J Med Educ

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The ubiquity of uncertainty: a scoping review on how undergraduate health professions’ students engage with uncertainty

Moffett

Hammond

Murphy

et al. 2021

Adv in Health Sci Educ

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Although the evidence base around uncertainty and education has expanded in recent years, a lack of clarity around conceptual terms and a heterogeneity of study designs means that this landscape remains indistinct. This scoping review explores how undergraduate health professions' students learn to engage with uncertainty related to their academic practice. To our knowledge, this is the first scoping review which examines teaching and learning related to uncertainty across multiple health professions. The scoping review is underpinned by the five-stage framework of (Arksey and O'Malley in Scoping studies: Towards a methodological framework International Journal of Social Research Methodology 8(1) 19-32, 2005). We searched MEDLINE, Embase, PsychINFO, ISI Web of Science, and CINAHL and hand-searched selected health professions’ education journals. The search strategy yielded a total of 5,017 articles, of which 97 were included in the final review. Four major themes were identified: “Learners’ interactions with uncertainty”; “Factors that influence learner experiences”; “Educational outcomes”; and, “Teaching and learning approaches”. Our findings highlight that uncertainty is a ubiquitous concern in health professions’ education, with students experiencing different forms of uncertainty at many stages of their training. These experiences are influenced by both individual and system-related factors. Formal teaching strategies that directly support learning around uncertainty were infrequent, and included arts-based teaching, and clinical case presentations. Students also met with uncertainty indirectly through problem-based learning, clinical teaching, humanities teaching, simulation, team-based learning, small group learning, tactical games, online discussion of anatomy topics, and virtual patients. Reflection and reflective practice are also mentioned as strategies within the literature.

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Six hours to study: temporality and ignorance in medical education

Knopes

2021

Anthropology & Medicine

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Medical Uncertainty in Students Entering Medical School

Cited by 4 publications

References 25 publications

Epistemic cognition in medical education: a literature review

Epistemic cognition in medical education: a literature review

The ubiquity of uncertainty: a scoping review on how undergraduate health professions’ students engage with uncertainty

Six hours to study: temporality and ignorance in medical education

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