Medical Students’ Reactions to Uncertainty During Clinical Rotations

Abstract

Background and Objectives: Family physicians routinely manage uncertainty in their clinical practice. During their first year of clinical rotations, medical students learn communication and patient care skills that will influence the care they provide as future physicians. However, little is known about how their reactions to uncertainty change during this formative year, and medical education often fails to teach students how to manage uncertainty effectively. This study employs a repeated measures analysis of students’ reactions to uncertainty over the course of their third year. Methods: We surveyed 273 medical students at four time points during their third year and employed hierarchical linear modeling to analyze a series of models in which phase and intolerance of uncertainty were entered as covariates. We modeled age and gender as control variables. Results: Analyses revealed that students’ affective reactions to uncertainty did not significantly change during the third year, but reluctance to disclose uncertainty to physicians and patients significantly decreased across phases. Analyses also showed that general intolerance of uncertainty predicted affective reactions to medical-specific uncertainty. Conclusions: These findings confirm that students experience negative reactions to uncertainty during clinical rotations. Students would benefit from curriculum designed to mitigate consequences of negative affective reactions to uncertainty, particularly those students characteristically higher in intolerance of uncertainty. Given that students demonstrated more willingness to communicate about their uncertainty over time, medical school should equip students with the communication skills needed to discuss their uncertainty effectively with patients and preceptors.