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Medical Uncertainty of Future Physicians: Socialization and Uncertainty Management in Medical Education

Journal: Unpublished PhD thesis Ohio University, Date: 2023/08, Pages: 173, type of study: qualitative study

Full text    (https://etd.ohiolink.edu/apexprod/rws_olink/r/1501/10?clear=10&p10_accession_num=ohiou1681475639569332)

Keywords:

medical students [402]
osteopathic medicine [1540]
qualitative study [209]
uncertainty [2]
USA [1086]

Abstract:

This dissertation explores how socialization around medical uncertainty is managed within medical education through the lenses of Uncertainty Management Theory (UMT, Brashers, 2001), Anticipatory Vocational Socialization (Jablin 1985), and Narrative Sensemaking (Charon, 2006). Using an interpretive framework and crystalized methodological approach, I worked with Ohio University Heritage College of Osteopathic Medicine (OUHCOM) to conduct 12 in-depth interviews guided by narrative maps, observed 24 standardized patient interactions, and penned auto-ethnographic reflections. This project was informed by three research questions: When, where, and how do students encounter uncertainty in medical school? How do students learn to understand, appraise, and manage uncertainty? What is the role of narrative pedagogies in preparing students to understand, appraise, and manage uncertainty? In chapter one, I offer an introduction to uncertainty focusing on the sources of uncertainty, how uncertainty was influenced by COVID-19, and uncertainty in medically under-resourced areas. In chapter two, I provide the theoretical sensibilities for this project drawing on UMT, Vocational Anticipatory Socialization, and Narrative Sensemaking in Healthcare Context and how these three theoretical frameworks are relevant for understanding how the negotiation of medical uncertainty within the organizational structures of medical school. In chapter three, I provide an overview of the methodology I used to address my research question. Chapter four is an auto-ethnographic perspective on the intersection of medical knowledge uncertainty and the global pandemic. In chapter five I highlight four themes that arose from my data collected with medical students and faculty that represented the ways OUHCOM as a medical education organization socialized medical students to manage uncertainty. Finally, in chapter six, I conclude with a discussion of the research questions and offer limitations, practical implications, and future directions.


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