Understanding uncertainty in medicine: concepts and implications in medical education

Kim, Kangmoon; Lee, Young Mee

doi:10.3946/kjme.2018.92

Cited by 73 publications

(63 citation statements)

References 43 publications

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“…With the shift towards competency‐based education, processes that were traditionally implicit and belonged to the hidden curriculum have become explicit learning goals (Hafferty and Castellani ). Learning to manage uncertainty is one such process, as medical educators have increasingly emphasised the need to prepare trainees to deal with uncertainty (Kim and Lee , Simpkin and Schwartzstein , Tonelli and Upshur , Wray and Loo ). In the United States, paediatric residents (physicians who completed medical school and are training to become paediatricians under the supervision of fellows and attending physicians) now have to ‘recognize the need for and to utilize appropriate resources in dealing with uncertainty’ in order to complete their training (ACGME : 23).…”

Section: Uncertainty In Medical Educationmentioning

confidence: 99%

Learning to manage uncertainty: supervision, trust and autonomy in residency training

Bochatay

Bajwa

2020

Sociology Health & Illness

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Sociologists have debated whether and how medical trainees are socialised to deal with uncertainty for decades. Recent changes in the structure of medical education, however, have likely affected the ways that resident physicians learn to manage uncertainty. Through ethnographic case studies of academic medical centres in Switzerland and the United States, this article provides new insights into the processes through which residents learnt to manage uncertainty. These processes included working under supervision, developing relationships of trust with supervisors and gaining autonomy to practise independently. As a result, residents developed different attitudes towards uncertainty. Residents at the Swiss medical centre tended to develop a more pragmatic attitude and viewed uncertainty as something to be addressed and controlled. On the other hand, residents at the American medical centre tended to develop an acceptive attitude towards uncertainty. More broadly, residents learnt to reproduce their supervisors’ attitudes towards uncertainty. This article therefore provides new perspectives on continuity and the reproduction of social phenomena in medical education.

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Section: Uncertainty In Medical Educationmentioning

confidence: 99%

Learning to manage uncertainty: supervision, trust and autonomy in residency training

Bochatay

Bajwa

2020

Sociology Health & Illness

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“…Health care professionals exercise judgement and decision making in often ill‐defined and unfamiliar contexts, a task that requires a degree of tolerance to uncertainty . The Collins English dictionary defines uncertainty as ‘a state of being uncertain about the future or doubt about what is the right thing to do’.…”

Section: Uncertainty In Clinical Practicementioning

confidence: 99%

Well‐being and uncertainty in health care practice

George

Lowe

2019

The Clinical Teacher

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Summary Background Well‐being and uncertainty are intimately related, although less easily defined from a health care perspective. Uncertainty is intrinsic to both the science and practice of health care, and dealing with uncertainty can bring feelings of stress, avoidance and resistance, all of which are detrimental to an individual's well‐being. Context Contrary to the majority of the literature, which suggests promoting resilience as a way to improve health care professionals’ well‐being, our paper argues that a better understanding of the relationship between well‐being and uncertainty can support health care professionals in managing the complexity of everyday clinical interactions. Innovation Various strategies and educational exercises around being comfortable in not knowing, preserving uncertainty through effective communication and the use of reflective silence are discussed to support clinical educators in recognising the impact of uncertainty on individual well‐being. Implications Our paper calls for a broader understanding of the term well‐being, recognising the interplay between individual and environmental factors that contribute to maintaining our well‐being. The recommended strategies and exercises can be considered in faculty member development sessions and used to promote the incorporation of curriculum initiatives in this area.

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“…Previous studies have emphasized the importance of diversity in teaching medicine, particularly in the eld of primary care [18]. Physicians must respect the diversity of patient values and societal needs.…”

Section: Introductionmentioning

confidence: 99%

What is the Impact of the Rashomon Approach in Primary Care Education?: An Educational Care Report of Implementing Dialogue and Improvisation Into Medical Education

Takamura

Imafuku

2020

Preprint

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Background:The excessive sub-divided or concrete pre-determined objectives found in the technological approach in contemporary medical education curricula may hinder the students’ spontaneous learning about diverse needs and values in care. However, medical professionals must learn the diversity for care or a variety of social factors of the patients influencing decision making in daily practice.Methods:We introduced a new method of curriculum development called the Rashomon approach. For testing the Rashomon approach, educational activities to teach the diversity in primary care were developed in four modules: 1) explication of the competency without specifying sub-objectives; 2) dialogue among multiple professional students; 3) visits and interviews of the patients; 4) dialogue with teachers' improvisation. The students’ outcomes and responses were quantitatively and qualitatively analyzed.Results:A total of 135 medical students joined this study in 2017. The descriptive data suggested that the key concepts of diversity in primary care were fully recognized and that the pre-determined general goals were achieved. Scores on the understanding of social factors in medicine, respect for other professionals, professional identity, and satisfaction with the course were very high.Conclusion:Instead of the technological approach, the Rashomon approach, in which only a general goal guides educational activities was used in this research. Improvisation and dialogue fit the approach and were potentially effective activities to learn the multifaceted practice of medicine. In an era of competency-based education, the Rashomon approach could be a very useful framework in primary care education.

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Understanding uncertainty in medicine: concepts and implications in medical education

Cited by 73 publications

References 43 publications

Learning to manage uncertainty: supervision, trust and autonomy in residency training

Learning to manage uncertainty: supervision, trust and autonomy in residency training

Well‐being and uncertainty in health care practice

What is the Impact of the Rashomon Approach in Primary Care Education?: An Educational Care Report of Implementing Dialogue and Improvisation Into Medical Education

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