title: Temporal changes in tolerance of uncertainty among medical students: insights from an exploratory study.
abstract: BACKGROUND
  Physicians' tolerance of uncertainty (TU) is a trait potentially associated with desirable outcomes, and emerging evidence suggests it may change over time. Past studies of TU, however, have been cross-sectional and have not measured tolerance of the different, specific types of uncertainty that physicians confront. We addressed these limitations in a longitudinal exploratory study of medical students.
  
  
  METHODS
  At the end of medical school (Doctor of Medicine degree) Years 1 and 4, a cohort of 26 students at a US medical school completed measures assessing tolerance of different types of uncertainty: 1) complexity (uncertainty arising from features of information that make it difficult to comprehend); 2) risk (uncertainty arising from the indeterminacy of future outcomes); and 3) ambiguity (uncertainty arising from limitations in the reliability, credibility, or adequacy of information). Change in uncertainty-specific TU was assessed using paired t-tests.
  
  
  RESULTS
  Between Years 1 and 4, there was a significant decrease in tolerance of ambiguity (t=3.22, p=0.004), but no change in students' tolerance of complexity or risk.
  
  
  CONCLUSIONS
  Tolerance of ambiguity--but not other types of uncertainty--decreases during medical school, suggesting that TU is a multidimensional, partially mutable state. Future studies should measure tolerance of different uncertainties and examine how TU might be improved.
authors.affiliation: Center for Outcomes Research and Evaluation, Maine Medical Center, Portland, ME, USA; hanp@mmc.org.
authors.forename: Paul K J
authors.initials: PK
authors.lastname: Han
authors.affiliation: Internal Medicine Residency Program, Mayo School of Graduate Medical Education, Mayo Clinic, Rochester, MN.
authors.forename: Daniel
authors.initials: D
authors.lastname: Schupack
authors.affiliation: Center for Outcomes Research and Evaluation, Maine Medical Center, Portland, ME, USA.
authors.forename: Susannah
authors.initials: S
authors.lastname: Daggett
authors.affiliation: Department of Family Medicine, Maine Medical Center, Portland, ME, USA.
authors.forename: Christina T
authors.initials: CT
authors.lastname: Holt
authors.affiliation: Department of Emergency Medicine, Maine Medical Center, Portland, ME, USA.
authors.forename: Tania D
authors.initials: TD
authors.lastname: Strout
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D015203:Reproducibility of Results; D018570:Risk Assessment; D013337:Students, Medical / Q000523:psychology*; D013997:Time Factors; D035501:Uncertainty
keywords: ambiguity; medical students; tolerance; uncertainty