Physicians' Reactions to Uncertainty: Refining the constructs and scales

Gerrity, Martha S.; White, Kinnard; DeVellis, Robert F.; Dittus, Robert S.

doi:10.1007/bf02250510

Cited by 148 publications

(233 citation statements)

References 23 publications

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“…The revised PRU scale is a validated 15-item questionnaire that provides short, conceptually clear, psychometrically sound measures of physicians' emotional reactions to uncertainty. 20 The PRU addresses four areas: anxiety caused by uncertainty, concern about bad outcomes, reluctance to disclose uncertainty to patients, and reluctance to disclose mistakes to physicians; the scale ranges from 15 to 90 with higher numbers correlating with greater anxiety and concern regarding uncertainty. Job satisfaction was measured with a validated two-part questionnaire, which consisted of the Emergency Physician Job Satisfaction (EPJS) instrument, and the Global Job Satisfaction (GJS) instrument.…”

Section: Study Protocolmentioning

confidence: 99%

Factors Associated With Burnout During Emergency Medicine Residency

Takayesu

Ramoska

Clark

et al. 2014

Academic Emergency Medicine

163

134

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Objectives: While the prevalence of burnout in practicing emergency physicians has been studied, little is known of the prevalence and risk factors in emergency medicine (EM) residents. The aim of this study was to assess the prevalence of burnout among EM residents and the individual-level factors associated with burnout.Methods: Eight EM residency programs were surveyed using the Maslach Burnout Inventory (MBI). Demographic data and data on job satisfaction and tolerance of uncertainty in clinical decision-making were collected using validated instruments.Results: Of 289 eligible residents, 218 completed the MBI (response rate = 75%). A total of 142 residents (65%) met the criteria for burnout. Complete data sets of the other instruments were obtained from 193 (response rate = 67%), and this group comprised our study population. Subjects having a significant other or spouse had a higher prevalence of burnout compared to single residents (60% vs. 40%, p = 0.002). Poor global job satisfaction (p < 0.0001), lack of administrative autonomy (p = 0.021), and lack of clinical autonomy (p = 0.031) correlated with burnout, as did intolerance of uncertainty (p = 0.015).Conclusions: Burnout is highly prevalent in EM residents. Interventions should be targeted at 1) improving resident autonomy in the emergency department where possible, 2) supervision and instruction on medical decision-making that may affect or teach individuals to cope with risk tolerance, and 3) social supports to reduce work-home conflicts during training.

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Section: Study Protocolmentioning

confidence: 99%

Factors Associated With Burnout During Emergency Medicine Residency

Takayesu

Ramoska

Clark

et al. 2014

Academic Emergency Medicine

163

134

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“…Scaled variables from each survey were scored according to described methods [10][11][12][13][14] for summarizing factor or construct scores, handling missing items, and reverse scoring. Analysis of variance (ANOVA) was used to compare individual variables and subscale scores for all surveys.…”

Section: Resultsmentioning

confidence: 99%

“…Many training programs are investing considerable time and energy to bolster resident resilience and decrease burnout with wellness programs. [16][17] Intolerance of clinical uncertainty also has repercussions for clinical care, as studies show that as physician anxiety about unclear clinical situations increases diagnostic testing and costs of care. 12,18 One estimate suggests that 17% of excessive medical costs arise from physician uncertainty about diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…12,18 One estimate suggests that 17% of excessive medical costs arise from physician uncertainty about diagnosis. 17 While written guidelines regarding physician/patient communication in the face of clinical uncertainty exist, 21 physicians may be reluctant to disclose their uncertainty to patients due to assumptions about perceived lack of skill or knowledge. 2 Other studies have unexpectedly shown that increased physician uncertainty led to improved patient satisfaction in shared decision-making models.…”

Section: Discussionmentioning

confidence: 99%

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A Pilot Study to Address Tolerance of Uncertainty Among Family Medicine Residents

Taylor

Picker

Woolever

et al. 2018

Fam Med

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Background and Objectives: Because patients often present to their family physicians with undifferentiated medical problems, uncertainty is common. Family medicine residents must manage both the ambiguity inherent in the field as well as the very real uncertainty of learning to become a skilled physician with little experience to serve as a guide. The purpose of this analysis was to assess the impact of a new curriculum on family medicine residents’ tolerance of ambiguity. Methods: We conducted an exploratory quasi-experimental study to assess the impact of a novel curriculum designed to improve family medicine residents’ tolerance of ambiguity. Four different surveys were administered to 25 family medicine residents at different stages in their training prior to and immediately and 6 months after the new curriculum. Results: Although many constructs remained unchanged with the intervention, one important construct, namely perceived threats of ambiguity, showed significant and sustained improvement relative to before undertaking this curriculum (score of 26.2 prior to the intervention, 22.1 immediately after, and 22.0 6 months after the intervention). Conclusions: A new curriculum designed to improve tolerance to ambiguity appears to reduce the perceived threats of ambiguity in this small exploratory study.

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“…Laegens reaktioner herpå er typisk, at han/hun ikke ønsker at afsløre sin usikkerhed over for patienten og ikke vil afsløre evt. fejl over for sine kolleger (Gerrity et al 1995).…”

Section: Artiklen Bygger På En Gennemgang Af Li2eratur Om Laegers Usiunclassified

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Physicians' Reactions to Uncertainty: Refining the constructs and scales

Cited by 148 publications

References 23 publications

Factors Associated With Burnout During Emergency Medicine Residency

Factors Associated With Burnout During Emergency Medicine Residency

A Pilot Study to Address Tolerance of Uncertainty Among Family Medicine Residents

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