Tolerance of uncertainty of medical students and practicing physicians.

ABSTRACT

BACKGROUND: Tolerance of uncertainty is believed to be an important attribute of practicing physicians. This study attempts to (1) estimate how medical students perceive physicians' tolerance of uncertainty and (2) measure the tolerance of uncertainty of practicing physicians. RESEARCH DESIGN: Cross-sectional. SETTING AND SUBJECTS: Medical students (n = 113) and practicing physicians (n = 151) at the Faculty of Health Sciences, Ben-Gurion University, Israel. MEASURES: A self-administered, Hebrew version of an instrument developed in the United States. INDEPENDENT VARIABLES Age, gender, seniority (year of study for students or years in practice for physicians), country of birth for students or of graduation for physicians, and physicians' specialty. DEPENDENT VARIABLES Two dimensions, which were identified by factor analysis: reluctance to disclose uncertainty and stress from uncertainty. RESULTS: The estimates of physicians' stress from uncertainty by first-year students aged <22 years were higher than those by first-year students aged > or =22 years. There were no significant differences in the way junior and senior medical students perceived physicians' tolerance of uncertainty. Stress from uncertainty was higher in female physicians (P = 0.028) and in graduates of the former Soviet Union (P = 0.044) than among male physicians and Israeli graduates, respectively. Reluctance to disclose uncertainty was higher among graduates of the former Soviet Union (P = 0.003) and among psychiatrists (P = 0.021) than among Israeli graduates and other specialties, respectively. CONCLUSIONS: The reliability and factor structure of the instrument were replicated. The previously reported differences in tolerance of uncertainty between women and men and between local and foreign graduates were confirmed. Physicians' tolerance of uncertainty appeared to be higher than that attributed to them by students. The expected age-related differences in perception of clinical uncertainty were not detected between junior and senior medical students.