Exploring Uncertainty Tolerance In Monash University Medical Students
Introduction: There is growing attention on uncertainty tolerance (UT) as a medical training competency, including assessment with UT scales. Yet little is known about how medical students experience uncertainty, nor factors that impact UT development. Accordingly, this research asked: ‘How do medical students experience and manage (i.e. tolerate) uncertainty?’, aiming to explore UT in preclinical and clinical students, and to evaluate the reliability and validity of UT scales in this population. Methods: Medical student experiences of uncertainty were explored through longitudinal qualitative research, using online forums, semi-structured interviews and reflective diaries. Evidence for UT scale reliability and validity was evaluated through systematic review and meta-analysis, including meta-analysis of Cronbach’s alphas, and assessment of multiple forms of validity evidence. Results: Students described a range of uncertainties: some related to learning medicine, others extended to professional and personal uncertainties. Multiple factors appeared to impact students’ UT, and were predominantly socially determined. Although responses to uncertainty described were predominantly negative (e.g. worry), reflections on uncertainty were predominantly positive (e.g. identifying learning opportunities). Meta-analysis of UT scale reliability identified significantly lower reliability among medical students than doctors. Validity evidence for UT scales was critically lacking for response processes. Conclusion: This research highlights avenues for educational intervention that could develop students’ UT, including student- (e.g. reflective learning) and educator- (e.g. role modelling UT) led interventions. Currently, there is inadequate evidence for UT scale psychometrics among medical student populations, thus implementing these scales in high-stakes applications is cautioned. Future research exploring reasons underpinning identified population differences in UT scale reliability is warranted.