Navigating Uncertainty in Patient Care: A CLoser Look at Emergency Medicine Residents in Brazil

Author:

Boemeke Gabriela1,Barbosa Larissa2,Quintanilha Luiz2,Avena Kátia3,Andrade Bruno3

Affiliation:

1. FAMINAS

2. Zarns Medical College

3. Oswaldo Cruz Foundation

Abstract

Abstract

Background. In emergency situations, the inexperience and complexity of cases can lead to uncertainty and stress among doctors, affecting their decision-making and negatively impacting patients and the healthcare system. Despite the importance of this topic, studies on uncertainty among Emergency Medicine residents are limited. Aim. Our study aims to investigate decision-making uncertainty among Emergency Medicine residents (EMR), identifying the most affected dimensions and assessing the impact of sociodemographic and academic profiles. Methods. This is a cross-sectional study that includes EMR in Brazil, with no restrictions on the year of specialization. Data was collected using the snowball method through an anonymous, structured electronic form distributed via virtual groups and e-mail. Measurements included sociodemographic and academic questions, as well as the application of the Physicians Reactions to Uncertainty (PRU) questionnaire, which quantifies physicians' uncertainty in decision-making. Results. A total of 124 residents participated in the study, with the majority being women (52.4%), over 26 years old (77.4%), in their first year of residency (49.2%), and without previous graduation on other academic fields (94.7%) or prior medical specializations and residencies (91.9%). The year of residency significantly influenced the perception of uncertainty, with first-year residents showing less ability to handle it (p=0.003). Participants with prior graduation in health-related fields aside from medicine and those with prior specializations demonstrated less intense reactions to uncertainty (p=0.041 and p=0.036, respectively). First-year residents experienced greater stress related to uncertainty (p<0.001), while those with previous graduation other than medicine were less reluctant to share their mistakes (p=0.003). Conclusion. Experience, in terms of years of residency or prior graduations, significantly impacts physicians' reactions, reducing perceived uncertainty and mitigating its emotional and cognitive impact. This can directly influence clinical decisions, behaviors, and overall well-being.

Publisher

Springer Science and Business Media LLC

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4. The work of recently graduated physicians in emergency services;Campos MCG;Rev Soc Bras Clin Med,2013

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