Accepted Type
Oral
Code
OC2-2-3
Acceptance Declaration
Accept
Additional Information
I declare I have no actual or potential conflict of interest in relation to this program.
Was this work accepted for CCME 2020?
no
Category
General Call (Workshop, Oral Presentation, Poster Presentation)
Type
Oral
Sub Type
Education Research
Will the presenter be a:
Resident
Affiliation
Considered for Poster
yes
Title
"One step away from 'you don't know what you're doing'": A qualitative study exploring perspectives of uncertainty among residents and early career clinicians
Length of Presentation
Background/Purpose
Current competency frameworks reflect the inevitability of uncertainty in clinical practice. Such frameworks emphasize that all trainees must learn to recognize and respond to uncertainty. Yet it remains unclear how trainees can learn this skill when the dominant ethos of medical training equates competence with absolute certainty. Thus, we sought to explore how early career clinicians (ECC) and residents understand the significance of clinical uncertainty and its relationship with competence.
Methods
Using Constructivist Grounded Theory, we conducted semi-structured interviews with 13 residents and 11 ECC (n=24), from ten different specialties. Iterative data collection and analysis directed constant comparison and theoretical sampling to sufficiency.
Results
Our analysis developed three main dimensions of uncertainty: (1) Trajectories of uncertainty, (2) Performances of (un)certainty and 3) Pedagogies of uncertainty. Trajectories captured the dynamic, non-linear relationship between uncertainty and experience. Performances highlighted how declarations of uncertainty are often constrained by gendered social norms and other implicit biases. Pedagogies identified the predominantly informal curriculum that shapes how our participants made inward and outward judgements of competence in light of uncertainty.
Conclusion
Our analysis reveals a complexity that is not captured by existing competency frameworks, which position "managing uncertainty" as a skill that is straightforwardly mastered during training. Rather, our participants described a non-linear evolution in how they both managed and understood the significance of uncertainty in their clinical practice. A lack of intentional, structured curriculum enables implicit biases about uncertainty and its relationship with competence to persist.
Keyword 1
Uncertainty
Keyword 2
Competence
Keyword 3
Qualitative
Level of Training
General
Abstract Themes
Postgraduate
Additional Theme (First choice)
Continuing Medical Education
Additional Theme (Second Choice)
Additional Theme (Third Choice)
Authors
Presenter
Brittany Dellar
Term 1
Yes
Term 2
Yes
Term 3
Yes
Term 4
Yes
Term 5
Yes
