The chicken and the egg: Clinical reasoning and uncertainty tolerance

Richmond, Anna

Abstract

In this issue, Stephens et al. present their investigation into medical students' experiences of uncertainty.1 Although clinical uncertainty is ubiquitous in medical practice, development of uncertainty tolerance is too often left implicit, to the detriment of care and caregivers given that intolerance is associated with overuse of resources, burnout and psychological distress. Interestingly, Stephens et al. found that students reported greater experience of educational uncertainty (lack of clarity regarding how and what to learn), and professional uncertainty (who they would be as doctors), than clinical uncertainty (aspects of patient care). That clinical uncertainty was least often reported suggests a need for educators to broaden consideration of uncertainty. Educators should also consider whether the lack of reportage of clinical uncertainty is actually a reflection of students' reduced awareness, rather than reduced experience, of this common phenonenon. As students advance further in their training and develop their clinical reasoning skills, clinical uncertainty will be, as it is for practicing doctors, frequently encountered, leading me to agree with Stephens et al.,1 that greater attention should be paid to clinical uncertainty. In addition, an understanding of the relationship between tolerance of uncertainty and development of clinical reasoning is needed. In order to explore this further, I consider the age old dilemma of what came first, the chicken or the egg: that is, does tolerance of uncertainty derive from or cause improved clinical reasoning?

Citation

Richmond, A. (2022). The chicken and the egg: Clinical reasoning and uncertainty tolerance. Medical Education, 56(7), 696-698. https://doi.org/10.1111/medu.14814

• Journal Article Type: Article
• Acceptance Date: Apr 20, 2022
• Online Publication Date: Apr 25, 2022
• Publication Date: 2022-07
• Deposit Date: May 18, 2022
• Publicly Available Date: May 18, 2022
• Journal: Medical Education
• Print ISSN: 0308-0110
• Electronic ISSN: 1365-2923
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 56
• Issue: 7
• Pages: 696-698
• DOI: https://doi.org/10.1111/medu.14814
• Keywords: Education; General Medicine
• Public URL: https://nottingham-repository.worktribe.com/output/8132447
• Publisher URL: https://onlinelibrary.wiley.com/doi/10.1111/medu.14814