Tolerance of uncertainty, a construct describing individuals’ responses to perceived uncertainty, has relevancy across healthcare systems, yet little work explores the impact of education on medical students’ tolerance of uncertainty. While debate remains as to whether tolerance of uncertainty is changeable or static, the prevailing conceptual healthcare tolerance of uncertainty model (Hillen et al. in Soc Sci Med 180:62–75, 2017) suggests that individuals’ tolerance of uncertainty is influenced by so-called moderators . Evidence regarding education’s role as a moderator of tolerance of uncertainty is, however, lacking. Preliminary work exploring medical students’ professional identity formation within anatomy learning identified tolerance of uncertainty as a theme warranting further exploration. Extending from this work, our research question was: How does the anatomy education learning environment impact medical students’ tolerance of uncertainty ? To address this question, qualitative data were collected longitudinally across two successive cohorts through online discussion forums during semester and end of semester interviews. Framework analysis identified five stimuli of uncertainty, four moderators of uncertainty, and cognitive, emotional and behavioral responses to uncertainty with variable valency (positive and/or negative). Longitudinal data analyses indicated changes in stimuli, moderators and responses to uncertainty over time, suggesting that tolerance of uncertainty is changeable rather than static. While our findings support the Hillen et al. (Soc Sci Med 180:62–75, 2017) model in parts, our data extend this model and the previous literature. Although further research is needed about students’ development of tolerance of uncertainty in the clinical learning environment, we encourage medical educators to incorporate aspects of tolerance of uncertainty into curricular and learning environments.

中文翻译：

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探索教育对临床前医学生不确定性容忍度的影响：一项定性纵向研究

不确定性容忍度是一种描述个人对感知到的不确定性的反应的结构，在医疗保健系统中具有相关性，但很少有工作探讨教育对医学生不确定性容忍度的影响。虽然关于不确定性容忍度是可变的还是静态的仍有争议，但普遍存在的不确定性模型的概念性医疗容忍度（Hillen 等人在 Soc Sci Med 180:62–75, 2017 中）表明个人对不确定性的容忍度受其影响——叫版主。然而，缺乏关于教育作为对不确定性容忍度的调节作用的证据。在解剖学学习中探索医学生专业身份形成的初步工作将不确定性的容忍度确定为值得进一步探索的主题。从这项工作延伸，我们的研究问题是：解剖学教育学习环境如何影响医学生对不确定性的容忍度？为了解决这个问题，在学期和学期末访谈期间，通过在线讨论论坛纵向收集了两个连续队列的定性数据。框架分析确定了五种不确定性刺激物、四种不确定性调节剂，以及对不确定性的认知、情绪和行为反应，具有可变效价（积极和/或消极）。纵向数据分析表明，随着时间的推移，刺激、调节剂和对不确定性的反应会发生变化，这表明对不确定性的容忍度是可变的，而不是静态的。虽然我们的研究结果支持 Hillen 等人。(Soc Sci Med 180:62–75, 2017) 部分模型，我们的数据扩展了这个模型和以前的文献。