Uncertainty Management Strategies in Communication About Urinary Tract Infections.

Urinary tract infections (UTIs) are the most common bacterial infection, and yet the etiology, treatment, and prevention of UTIs are often clouded by uncertainty. UTIs can cause severe pain and may lead to serious infection, but communication about UTIs can help individuals manage this condition and avoid recurring UTIs. Grounded in uncertainty management theory (UMT), this study explored how individuals with female anatomy manage uncertainty surrounding UTIs. Iterative analysis was employed using UMT to analyze 21 qualitative interviews. Participants used uncertainty management strategies of talking to health care providers, eliciting social support, and using the internet to gather information. Results indicated that talking to heath care providers was a dominant strategy intended to reduce uncertainty about the diagnosis and treatment of their symptoms. However, these interactions inadvertently increased uncertainty as well, as providers did not provide information about the causes and prevention of UTIs. Some participants also engaged in deception to reduce uncertainty about how their providers would respond to their pain and their illness. Finally, participants employed metaphors to interpret and neutralize uncertainty related to their experiences. Implications for these findings include guidelines and support for patient and provider communication, communication in social networks, as well as deeper nuances and development for UMT.

"This Is Not the Hill to Die on. Even if We Literally Could Die on This Hill": Examining Communication Ecologies of Uncertainty and Family Communication About COVID-19.

As information about the public health risks surrounding COVID-19 continues to shift over time, families communicate to navigate this ongoing uncertainty. For example, families must interpret inconsistent media and public health messages about COVID-19, which may in turn have implications for health risk behavior. Adding to this complexity, household structures and routines are adapting in response to COVID-19. Adult family members in some families may suddenly experience extreme physical proximity, while others must coordinate to make decisions about their health and prevention behaviors while maintaining physical distance. Furthermore, members of these families must balance relational maintenance while communicating to assess and avoid health risks. The ongoing ambiguity of information about COVID-19 means that these relational processes must be managed in the midst of chronic uncertainty. The current study uses semistructured interviews and interpretive analysis to understand how adult children (aged 23-51 years) manage chronic uncertainty about COVID-19 in communication with their parents. Findings explore themes of navigating information about COVID-19 risks and protections, managing uncertainty management about media and political messages, and accepting time-related uncertainties.

Fostering students' reflection about bias in healthcare: cognitive dissonance and the role of personal and normative standards.

BACKGROUND: To reduce cognitive dissonance about one's beliefs or behavior, individuals may compare their behavior to personal and/or normative standards. The details of this reflection process are unclear. AIMS: We examined how medical students compare their behavior or beliefs to standards in discussions about implicit bias, and explored if and how different reflective pathways (preserving vs. reconciling) are associated with each standard. METHODS: Third-year students engaged in a small-group discussion about bias. Some students and group facilitators also participated in a debriefing about the experience. Using qualitative methods, the transcripts from these 11 sessions were analyzed for evidence of student comparison to a standard and of reflection pathways. RESULTS: Of 557 text units, 75.8% could be coded with a standard and/or a path of reflection. Students referenced personal and normative standards about equally, and preserved or reconciled existing beliefs about equally. Uses of normative standards were associated with preservation-type reflection, and uses of personal standards with reconciliation-type reflection. CONCLUSIONS: Normative expectations of physicians are sometimes used to provoke students' consideration of implicit biases about patients. To encourage critical reflection and reconciliation of biased beliefs or behavior, educators should frame reflective activities as a personal exercise rather than as a requirement.

A standards-based, peer-reviewed teaching award to enhance a medical school's teaching environment and inform the promotions process.

The authors provide the rationale, design, and description of a unique teaching award that has enhanced Baylor College of Medicine's teaching environment and become highly valued by the promotions and tenure (P&T) committee in determining a faculty member's readiness for promotion. This award is self-nominating and standards based. The primary purpose for development of the award was to provide the Baylor community and the P&T committee a method to understand and value the scholarship of teaching to the same degree that they understand and value the scholarship of discovery.The authors also present results from an internal evaluation of the program that included a survey and interviews. Between the inception of the award in 2001 and the internal review conducted in 2010, the award could have had an influence on the promotion of 130 of the recipients. Of the 130, 88 (65.6%) received this award before gaining their current rank (χ (1) = 16.3, P < .001). Stakeholders, including department chairs and members of the P&T committee, agreed that this award is valuable to those seeking promotion. Individual recipients stated that the award is good for the institution by encouraging reflection on teaching; increasing the recognition, importance, and value of teaching; encouraging the improvement of teaching skills; and providing a better understanding to others about what medical teachers really do. Of the 214 open-ended responses to survey questions of award recipients, more than half the comments were about the value of the award and its positive effect on promotion.