Have a personal or library account? Click to login
How Do Paediatricians Manage Comfort with Uncertainty in Clinical Decision-Making Cover

How Do Paediatricians Manage Comfort with Uncertainty in Clinical Decision-Making

Open Access
|Oct 2024

References

  1. Hatch S. Uncertainty in medicine. BMJ. 2017; 357: j2180. DOI: 10.1136/bmj.j2180
  2. Moffett J, Hammond J, Murphy P, Pawlikowska T. The ubiquity of uncertainty: a scoping review on how undergraduate health professions’ students engage with uncertainty. Adv Health Sci Educ. 2021; 26(3): 913958. DOI: 10.1007/s10459-021-10028-z
  3. Fargason CA, Jr, Evans HH, Ashworth CS, Capper SA. The importance of preparing medical students to manage different types of uncertainty. Acad Med. 1997; 72(8): 688692. DOI: 10.1097/00001888-199708000-00013
  4. Koerner N, Dugas MJ. An investigation of appraisals in individuals vulnerable to excessive worry: the role of intolerance of uncertainty. Cogn Ther Res. 2008; 32: 619638. DOI: 10.1007/s10608-007-9125-2
  5. Ilgen JS, Eva KW, de Bruin A, Cook DA, Regehr G. Comfort with uncertainty: reframing our conceptions of how clinicians navigate complex clinical situations. Adv Health Sci Educ. 2019; 24(4): 797809. DOI: 10.1007/s10459-018-9859-5
  6. Raia F, Legados L, Silacheva I, et al. What is that’s going on here? A multidimensional time concept is foundational to framing for decision making in situations of uncertainty. Cult Stud of Sci Educ. 2021; 16: 881913. DOI: 10.1007/s11422-021-10063-7
  7. Wray CM, Loo LK. The Diagnosis, Prognosis, and Treatment of Medical Uncertainty. J Grad Med Educ. 2015; Dec 7(4): 5237. DOI: 10.4300/JGME-D-14-00638.1
  8. Gerrity MS, DeVellis RF, Earp JA. Physicians’ reactions to uncertainty in patient care. A new measure and new insights. Med Care. 1990; 28(8): 724736. DOI: 10.1097/00005650-199008000-00005
  9. Simpkin AL, Schwartzstein RM. Tolerating Uncertainty – The Next Medical Revolution? New Eng J Med. 2016; 375(18): 17131715. DOI: 10.1056/NEJMp1606402
  10. Ghosh AK. Understanding medical uncertainty: a primer for physicians. J Assoc Phys India. 2004; 52: 739742.
  11. Helou MA, DiazGranados D, Ryan MS, Cyrus JW. Uncertainty in Decision Making in Medicine: A Scoping Review and Thematic Analysis of Conceptual Models. Acad Med1 2020; 95(1): 157165. DOI: 10.1097/ACM.0000000000002902
  12. Nevalainen MK, Mantyranta T, Pitkala KH. Facing uncertainty as a medical student—a qualitative study of their reflective learning diaries and writings on specific themes during the first clinical year. Pt Educ Couns. 2010; 78(2): 218223. DOI: 10.1016/j.pec.2009.07.011
  13. Porteous DJ, Machin A. The lived experience of first year undergraduate student nurses: A hermeneutic phenomenological study. Nurse Educ Today. 2018; 60: 5661. DOI: 10.1016/j.nedt.2017.09.017
  14. Durrheim K, Foster D. Tolerance of ambiguity as a content specific construct. Personality and Individual Differences. 1997; 22(5): 741750. DOI: 10.1016/S0191-8869(96)00207-3
  15. Strout TD, Hillen, M, Gutheil C, Anderson E, Hutchinson R, Ward H, Kay H, Mills GJ, Han PKJ. Tolerance of uncertainty: A systematic review of health and healthcare-related outcomes. Pt Educ Couns. 2018; 101(9): 15181537. DOI: 10.1016/j.pec.2018.03.030
  16. Ilgen JS, Teunissen PW, de Bruin ABH, Bowen, JL, Regehr G. Warning bells: How clinicians leverage their discomfort to manage moments of uncertainty. Med Educ. 2021; 55(2): 233241. DOI: 10.1111/medu.14304
  17. Pines JM, Hollander JE, Isserman JA, et. al. The association between physician risk tolerance and imaging use in abdominal pain. Amer J Emerg Med. 2009; 27(5): 552557. DOI: 10.1016/j.ajem.2008.04.031
  18. Pines JM, Isserman JA, Szyld D, Dean, AJ, McCusker CM, Hollander JE. 2010. The effect of physician risk tolerance and the presence of an observation unit on decision making for ED patients with chest pain. Amer J Emerg Med. 28(7): 771779. DOI: 10.1016/j.ajem.2009.03.019
  19. Franks P, Williams GC, Zwanziger J, Mooney C, Sorbero M. Why do physicians vary so widely in their referral rates?. J Gen Int Med. 2000; 15(3): 163168. DOI: 10.1046/j.1525-1497.2000.04079.x
  20. Raglan GB, Babush M, Farrow VA, Kruglanski, A. W., & Schulkin, J. Need to know: the need for cognitive closure impacts the clinical practice of obstetrician/gynecologists. BMC Med Inform Dec Mak. 2014; 14: 122. DOI: 10.1186/s12911-014-0122-6
  21. Morrison ML, McCrossan BA, Sands AJ, Craig B, Casey FA, Grant B. Referrals to Pediatric Cardiology Outpatients: Continued Evidence of Increasing Workload. Clin Peds. 2016; 55(14): 13461349. DOI: 10.1177/0009922816632199
  22. Portnoy DB, Han PK, Ferrer RA, Klein WM, Clauser SB. Physicians’ attitudes about communicating and managing scientific uncertainty differ by perceived ambiguity aversion of their patients. Health Expect. 2013; 16(4): 362372. DOI: 10.1111/j.1369-7625.2011.00717.x
  23. White G, Williams S. The certainty of uncertainty: can we teach a constructive response? Med Educ. 2017; 51(12): 12001202. DOI: 10.1111/medu.13466
  24. Babrow AS, Kasch CR, Ford LA. The many meanings of uncertainty in illness: toward a systematic accounting. Health Comm. 1998; 10(1): 123. DOI: 10.1207/s15327027hc1001_1
  25. Han PK, Klein WM, Arora NK. Varieties of uncertainty in health care: a conceptual taxonomy. Med Dec Mak. 2011; 31(6): 828838. DOI: 10.1177/0272989x11393976
  26. Simpkin AL, Armstrong KA. Communicating Uncertainty: a Narrative Review and Framework for Future Research. J Gen Int Med. 2019; 34(11): 25862591. DOI: 10.1007/s11606-019-04860-8
  27. McMahon, CJ, Sendžikaitė S, Jegatheeswaran A, et. al. Managing uncertainty in decision-making of common congenital cardiac defects. Cardiol Young. 2022; 32(11): 17051717. DOI: 10.1017/S1047951122003316
  28. McMahon CJ, Gallagher S, James A, Deery A, Rhodes M, van Merriënboer JJG. Does high-variation training facilitate transfer of training in paediatric transthoracic echocardiography? Cardiol Young. 2021; 31(4): 602608. DOI: 10.1017/S1047951120004412
  29. Ryan A, Duignan S, Kenny D, McMahon CJ. Decision Making in Paediatric Cardiology. Are We Prone to Heuristics, Biases and Traps? Ped Cardiol. 2018; 39(1): 160167. DOI: 10.1007/s00246-017-1742-2
  30. Duignan S, Ryan A, O’Keeffe D, Kenny D, McMahon CJ. Prospective Analysis of Decision Making During Joint Cardiology Cardiothoracic Conference in Treatment of 107 Consecutive Children with Congenital Heart Disease. Ped Cardiol. 2018; 39(7): 13301338. DOI: 10.1007/s00246-018-1899-3
  31. Barreto-Filho JAS, Veiga A, Correia LC. COVID-19 and Uncertainty: Lessons from the Frontline for Promoting Shared Decision Making. COVID-19 e Incertezas: Lições do Frontline para a Promoção da Decisão Compartilhada. Arquivos brasileiros de cardiologia. 2020; 115(2): 149151. DOI: 10.36660/abc.20200582
  32. Muhrer JC. The importance of the history and physical in diagnosis. Nurse Pract. 2014; 39(4): 3036. DOI: 10.1097/01.NPR.0000444648.20444.e6
  33. Marewski JN, Gigerenzer G. Heuristic decision making in medicine. Dial Clin Neuroscience. 2012; 14(1): 7789. DOI: 10.31887/DCNS.2012.14.1/jmarewski
  34. Marewski, J. N., Gaissmaier, W., & Gigerenzer, G. Good judgments do not require complex cognition. Cognitive processing. 2010; 11(2): 103121. DOI: 10.1007/s10339-009-0337-0
  35. Reb J, Luan S, Gigerenzer G. Smart management how simple heuristics help make good decisions in an uncertain world. Publishers MIT Press; 2014.
  36. Ilgen JS, Bowen JL, de Bruin ABH, Regehr G, Teunissen PW. “I Was Worried About the Patient, but I Wasn’t Feeling Worried”: How Physicians Judge Their Comfort in Settings of Uncertainty. Acad Med. 2020; 95(11S): S67S72. DOI: 10.1097/ACM.0000000000003634
  37. Zavala AM, Day GE, Plummer D, Bamford-Wade A. Decision-making under pressure: medical errors in uncertain and dynamic environments. Austral Health Rev. 2018; 42(4): 395402. DOI: 10.1071/AH16088
  38. Gordon M, Patricio, M, Horne L, et. al. Developments in medical education in response to the COVID-19 pandemic: A rapid BEME systematic review: BEME Guide No. 63. Med Teach. 2020; 42(11): 12021215. DOI: 10.1080/0142159X.2020.1807484
  39. Vallée A, Blacher J, Cariou A, Sorbets E. Blended Learning Compared to Traditional Learning in Medical Education: Systematic Review and Meta-Analysis. J Med Int Res. 2020; 22(8): e16504. DOI: 10.2196/16504
  40. Moran AM, Coyle J, Pope R, Boxall D, Nancarrow SA, Young J. Supervision, support and mentoring interventions for health practitioners in rural and remote contexts: an integrative review and thematic synthesis of the literature to identify mechanisms for successful outcomes. Human Res Health. 2014; 12: 10. DOI: 10.1186/1478-4491-12-10
  41. Koocher GP. Psychosocial care of the child cured of cancer. Ped Nursing. 1985; 11(2): 9193.
  42. Nixon J, Wolpaw T, Schwartz A, Duffy B, Menk J, Bordage G. SNAPPS-Plus: an educational prescription for students to facilitate formulating and answering clinical questions. Academic Med. 2014; 89(8): 11741179. DOI: 10.1097/ACM.0000000000000362
  43. Sawanyawisuth K, Schwartz A, Wolpaw T, Bordage G. Expressing clinical reasoning and uncertainties during a Thai internal medicine ambulatory care rotation: does the SNAPPS technique generalize? Med Teach. 2015; 37(4): 379384. DOI: 10.3109/0142159X.2014.947942
  44. Madeo AC, O’Brien KE, Bernhardt BA, Biesecker BB. Factors associated with perceived uncertainty among parents of children with undiagnosed medical conditions. Amer J Med Genetics. Part A. 2012; 158A(8): 18771884. DOI: 10.1002/ajmg.a.35425
  45. Gordon GH, Joos SK, Byrne J. Physician expressions of uncertainty during patient encounters. Pt Educ Couns. 2000; 40(1): 5965. DOI: 10.1016/s0738-3991(99)00069-5
  46. Balogh EP, Miller BT, Ball JR. Improving diagnosis in health care. board on health care services, institute of medicine, & the national academies of sciences, engineering, and medicine, editors. Improving Diagnosis in Health Care. National Acadmies Press (US); 2015. DOI: 10.17226/21794
  47. Zhang B, Shou Y. Immediate emotions and subjective stakes in risky decision-making under uncertainty. Anxiety, stress, and coping. 2022; 35(6): 649661. DOI: 10.1080/10615806.2021.1994143
  48. Hillen MA, Gutheil CM, Strout TD, Smets EMA, Han PKJ. Tolerance of uncertainty: Conceptual analysis, integrative model, and implications for healthcare. Social science & medicine (1982). 2017; 180: 6275. DOI: 10.1016/j.socscimed.2017.03.024
DOI: https://doi.org/10.5334/pme.1394 | Journal eISSN: 2212-277X
Language: English
Submitted on: Apr 28, 2024
|
Accepted on: Jun 24, 2024
|
Published on: Oct 22, 2024
Published by: Ubiquity Press
In partnership with: Paradigm Publishing Services
Publication frequency: 1 issue per year

© 2024 Colin J. McMahon, Muirne Spooner, Matthew Sibbald, Maryam Asoodar, published by Ubiquity Press
This work is licensed under the Creative Commons Attribution 4.0 License.