Uncertainty and Medical Education

  • Jonathan Sadler

Student thesis: Doctoral Thesis


Understanding how to manage uncertainty in medicine is an essential part of clinical practice. Doctors and medical students alike suffer emotional anguish when they are uncertain. Despite this, there has been little inclusion of recognised ways to manage uncertainty in medical school curricula. This is especially concerning for those practising in the United Kingdom, as being able to manage uncertainty is a recognised requirement by the General Medical Council. How to teach medical students to manage this phenomenon thus warrants further study.

In a review of the literature, eight published interventions were found where teaching healthcare learners about uncertainty was the focus. How doctors and students actually learned to manage their uncertainty was, however, still unclear. Through interviewing 11 medical educators and 11 medical students in semi structured interviews and focus groups, this thesis provides further insights into how to manage uncertainty. The medical educators described uncertainty in aleatoric terms, where possible outcomes were known but predicting which one would happen caused the uncertainty, and felt teaching should reflect this. However, medical educators felt that they themselves had learned about uncertainty over time and through non-specific clinical experiences rather than through direct teaching methods. The medical students described uncertainty in epistemic terms, where possible outcomes were unknown and infinite. They felt they had learned to manage this through interactions with near-peers and an acceptance that uncertainty was normal.

Analysing this data has revealed that students and doctors largely experience different forms of uncertainty. This implies that teaching needs to be intentionally tailored to the relevant audience based on their degree of clinical exposure. This thesis presents a proposal for managing uncertainty and lays the ground for future work that could test this proposal.
Date of AwardJun 2023
Original languageEnglish
Awarding Institution
  • University of Brighton
SupervisorClare Forder (Supervisor)

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