Submission ID 78134
| Code | OC-3-3 |
|---|---|
| At the end of this workshop, participants will be able to: | |
| Category | Medical Education |
| Type | Oral |
| Will the presenter be a: | Other |
| Presenter Other | Associate Professor |
| Title | A Concept Analysis of Ambiguity, Uncertainty, and Complexity in Clinical Reasoning |
| Background/Purpose | Medical practice is fraught with uncertainty, ambiguity, or complexity. Recognizing and responding to the uncertainty, ambiguity, and complexity of practice is an enabling competency of a Medical Expert in CanMEDS 2015.1 Despite attention, these concepts remain underspecified, making it challenging to develop teaching and assessment approaches to improve clinical reasoning. |
| Methods | With the Royal College as a knowledge user, we conducted a scoping review to map literature on ambiguity, uncertainty, and complexity in clinical reasoning. A search was developed, peer reviewed, and executed in five databases. Two coders screened abstracts. Analysis was done using concept analysis, which focuses on: objects (things that display the target concept), antecedents (what precedes the concept), attributes (key characteristics of the concept), and consequents (things that follow from the concept). |
| Results | 386 of 4527 abstracts screened were included. 'Complex(ity)' was used most frequently, followed by 'uncertain(ty)', and ambiguous/ambiguity. Ambiguous objects included patient characteristics, uncertainty included clinical processes and outcomes, and complexity included systems and processes. There were important areas of overlap across concepts, but several key differences in the use of the concepts were documented. Ambiguity was more about individual patient cases whereas complexity spanned from the patient to the system levels. Uncertainty was more tied to a clinician experience and seen as undesirable, whereas complexity was inherent to health care and necessitated. |
| Discussion | Findings provide an overview of existing ways these terms are used - including their interrelation and interdependence. More conceptual clarity is needed to support teaching and assessing clinical reasoning in complex/uncertain/ambiguous problems. |
| Keyword 1 | Clinical Reasoning |
| Keyword 2 | ambiguity |
| Keyword 3 | uncertainty |
| Abstract content most relevant to: (check all that apply) | Residency Education |
| Abstract Track - First Choice | Teaching and learning |
| Teaching and Learning | Clinical Context Clinical Skills Competency-Based Education |
| Authors | Meredith Young Valerie Dory Aliki Thomas Stuart Lubarsky Nazi Torabi Farhan Banji Steven Durning Meredith Young |
