Academic Journal
How Do Paediatricians Manage Comfort with Uncertainty in Clinical Decision-Making
| Title: | How Do Paediatricians Manage Comfort with Uncertainty in Clinical Decision-Making |
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| Authors: | Colin J. McMahon, Muirne Spooner, Matthew Sibbald, Maryam Asoodar |
| Source: | Perspect Med Educ Perspectives on Medical Education; Vol. 13 No. 1 (2024); 527–539 |
| Publisher Information: | Ubiquity Press, Ltd., 2024. |
| Publication Year: | 2024 |
| Subject Terms: | Male, Adult, Physician-Patient Relations, Clinical Decision-Making/methods, Interviews as Topic/methods, Clinical Decision-Making, Uncertainty, Pediatrics/methods standards, Pediatrics, Interviews as Topic, Humans, Female, Pediatricians, Ireland, Qualitative Research, Pediatricians/psychology, Original Research |
| Description: | Background: While healthcare practice is inherently characterised by uncertainty, there is a paucity of formal curricular training to support comfort with uncertainty (CWU) in postgraduate training. Indeed, some evidence suggests medical training inherently conflicts with CWU in emphasizing pedagogies focussing on “fixing” the problem. While referral patterns increase significantly, dealing with uncertainty has direct implications for patient referral rates and use of valuable healthcare resources. Methods: Paediatricians in Ireland were invited to participate. Face-to-face interviews were conducted after participants watched videos of varied clinician-patient interactions.. Two researchers independently analysed the collected data using thematic analysis. Triangulation and member checking was performed to ensure validity of findings. A reflection journal documented the research journey. Results: Thirty four paediatricians participated. Five themes were identified: the interplay between quality of information, uncertainty and decision-making, confidence in clinical assessment and first-hand patient evaluation, anxiety and fear experienced by medical professionals when dealing with complex and serious conditions, strategies employed by medical professionals in managing their own uncertainty and the impact of societal and parental expectations on medical decision-making. These are moderated by a number of factors, most significantly the child’s caregivers’ comfort with doctors reassurance (CDR). Enacted management will diverge from the consultant’s clinical plan when the caregiver’s CDR cannot be satisfactorily supported. Discussion: Clinician CWU in the paediatric context is inextricably linked to caregiver CDR. The complexities and central importance of social context in understanding CWU has important implications for how we develop educational activities to support clinician CWU and patient/care-giver CDR. This may translate to efficient use of limited resources in healthcare settings. |
| Document Type: | Article Other literature type |
| File Description: | application/pdf; text/xml |
| ISSN: | 2212-277X |
| DOI: | 10.5334/pme.1394 |
| Access URL: | https://pubmed.ncbi.nlm.nih.gov/39463798 https://cris.maastrichtuniversity.nl/en/publications/d2ec347c-b969-4692-9ba9-0a1b17fa1c08 https://doi.org/10.5334/pme.1394 https://account.pmejournal.org/index.php/up-j-pme/article/view/1394 |
| Rights: | CC BY URL: http://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC-BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See http://creativecommons.org/licenses/by/4.0/. |
| Accession Number: | edsair.doi.dedup.....b7e17ed6ca32f267eefc9b5fe6b58adb |
| Database: | OpenAIRE |
| ISSN: | 2212277X |
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| DOI: | 10.5334/pme.1394 |