Estrategias educativas para la tolerancia a la incertidumbre en estudiantes y profesionales sanitarios: Revisión sistemática.

Autores

DOI: https://doi.org/10.6018/edumed.576711
Palavras-chave: incertidumbre, ambigüedad, tolerancia, intolerancia, salud

Resumo

En las últimas décadas, el interés por la tolerancia a la incertidumbre (TI) en los profesionales de la salud ha ido en aumento. Una pobre capacidad de tolerar la incertidumbre se ha relacionado con mayores niveles de estrés y más probabilidades de padecer síndrome de burnout. Sin embargo, la TI no es considerada explícitamente en los currículos de las profesiones sanitarias siendo relegada su presencia al currículo oculto. Se hace necesario conocer que estrategias educativas pueden ser de utilidad al docente para abordar la TI en los futuros profesionales. La presente revisión tiene como objetivo identificar dichas estrategias educativas y cuál es su efectividad. Se realizó una búsqueda en las bases de datos “Pubmed”, “Scopus” y Cinahl” y tras aplicar un proceso de cribado, se seleccionaron 7 artículos que fueron analizados finalmente. Los resultados han identificado 3 modelos de estrategias educativas: “estrategias basadas en pensamiento visual”, “estrategias basadas en interacción con animales” y “estrategias educativas convencionales”. Concluimos destacando, por un lado, que ninguna estrategia ha mostrado mayor eficacia frente al resto y, por otro lado, la TI ha sido estudiada, fundamentalmente en el colectivo médico. Es importante que en un futuro se realicen investigaciones de mayor calidad y orientadas a todas las profesiones sanitarias.

Downloads

Não há dados estatísticos.

Metrics

Metrics Loading ...

Referências

Hillen, M.A.; Gutheil, C.M.; Strout, T.D.; Smets, E.M.A.; Han, P.K.J. Tolerance of Uncertainty: Conceptual Analysis, Integrative Model, and Implications for Healthcare. Soc Sci Med 2017, 180, 62–75, doi:10.1016/J.SOCSCIMED.2017.03.024.

Ghosh, A.K.; Joshi, S. Tools to Manage Medical Uncertainty. Diabetes and Metabolic Syndrome: Clinical Research and Reviews 2020, 14, 1529–1533, doi:10.1016/j.dsx.2020.07.055.

Helou, M.A.; DiazGranados, D.; Ryan, M.S.; Cyrus, J.W. Uncertainty in Decision Making in Medicine: A Scoping Review and Thematic Analysis of Conceptual Models. Acad Med 2020, 95, 157–165, doi:10.1097/ACM.0000000000002902.

Ilgen, J.S.; Eva, K.W.; Anique De Bruin, ·; Cook, D.A.; Regehr, G. Comfort with Uncertainty: Reframing Our Conceptions of How Clinicians Navigate Complex Clinical Situations. Advances in Health Sciences Education 2019, 24, 797–809, doi:10.1007/s10459-018-9859-5.

Kim, K.; Lee, Y.-M.; Kim, K.; Lee, Y.-M. Understanding Uncertainty in Medicine: Concepts and Implications in Medical Education. Korean J Med Educ 2018, 30, 181–188, doi:10.3946/KJME.2018.92.

Timmermans, S.; Angell, A. Evidence-Based Medicine, Clinical Uncertainty, and Learning to Doctor. J Health Soc Behav 2001, 42, 342–359, doi:10.2307/3090183.

Han, P.K.J.; Klein, W.M.P.; Arora, N.K. Varieties of Uncertainty in Health Care: A Conceptual Taxonomy. Medical Decision Making 2011, 31, 828–838, doi:10.1177/0272989x11393976.

Bhise, V.; Rajan, S.S.; Sittig, D.F.; Morgan, R.O.; Chaudhary, P.; Singh, H. Defining and Measuring Diagnostic Uncertainty in Medicine: A Systematic Review. J Gen Intern Med 2018, 33, 103–115.

Lee, C.; Hall, K.; Anakin, M.; Pinnock, R. Towards a New Understanding of Uncertainty in Medical Education. J Eval Clin Pract 2020, jep.13503, doi:10.1111/jep.13503.

Strout, T.D.; Hillen, M.; Gutheil, C.; Anderson, E.; Hutchinson, R.; Ward, H.; Kay, H.; Mills, G.J.; Han, P.K.J. Tolerance of Uncertainty: A Systematic Review of Health and Healthcare-Related Outcomes. Patient Educ Couns 2018, 101, 1518–1537.

Hancock, J.; Mattick, K. Tolerance of Ambiguity and Psychological Well-Being in Medical Training: A Systematic Review. Med Educ 2020, 54, 125–137, doi:10.1111/medu.14031.

Simpkin, A.L.; Khan, A.; West, D.C.; Garcia, B.M.; Sectish, T.C.; Spector, N.D.; Landrigan, C.P. Stress From Uncertainty and Resilience Among Depressed and Burned Out Residents: A Cross-Sectional Study. Acad Pediatr 2018, 18, 698–704, doi:10.1016/j.acap.2018.03.002.

Iannello, P.; Mottini, A.; Tirelli, S.; Riva, S.; Antonietti, A. Ambiguity and Uncertainty Tolerance, Need for Cognition, and Their Association with Stress. A Study among Italian Practicing Physicians. Med Educ Online 2017, 22, doi:10.1080/10872981.2016.1270009.

Luther, V.P.; Crandall, S.J. Commentary: Ambiguity and Uncertainty: Neglected Elements of Medical Education Curricula? Academic Medicine 2011, 86, 799–800, doi:10.1097/ACM.0b013e31821da915.

Ledford, C.J.W.; Seehusen, D.A.; Chessman, A.W.; Shokar, N.K. How We Teach Us Medical Students to Negotiate Uncertainty in Clinical Care: A Cera Study. Fam Med 2015, 47, 31–36.

Benjamin, A.J.; Riggio ’ , R.E.; Mayes, B.T. Reliability and Factor Structure of Budner’s Tolerance for Ambiguity Scale; 1996;

Gerrity, M.S.; Devellis, R.F.; Earp, J.A. Physicians’ Reactions to Uncertainty in Patient Care: A New Measure and New Insights. Care 1990, 28, 724–736.

Gerrity, M.S.; White, K.P.; DeVellis, R.F.; Dittus, R.S. Physicians’ Reactions to Uncertainty: Refining the Constructs and Scales. Motiv Emot 1995, 19, 175–191, doi:10.1007/BF02250510.

Politi, M.C.; Légaré, F. Physicians’ Reactions to Uncertainty in the Context of Shared Decision Making. Patient Educ Couns 2010, 80, 155–157, doi:10.1016/j.pec.2009.10.030.

Zimmermann, C.; Huang, J.T.; Buzney, E.A. Refining the Eye: Dermatology and Visual Literacy. Journal of Museum Education 2016, 41, 116–122, doi:10.1080/10598650.2016.1163189.

Fischer, K.; Sullivan, A.M.; Krupat, E.; Schwartzstein, R.M. Assessing the Effectiveness of Using Mechanistic Concept Maps in Case-Based Collaborative Learning. Academic Medicine 2019, 94, 208–212, doi:10.1097/ACM.0000000000002445.

Murphy, L.; Wilson, J.; Greenberg, S. Equine-Assisted Experiential Learning in Occupational Therapy Education. Journal of Experiential Education 2017, 40, 366–376, doi:10.1177/1053825917712732.

Strohbehn, G.W.; Hoffman, S.J.K.; Tokaz, M.; Houchens, N.; Slavin, R.; Winter, S.; Quinn, M.; Ratz, D.; Saint, S.; Chopra, V.; et al. Visual Arts in the Clinical Clerkship: A Pilot Cluster-Randomized, Controlled Trial. BMC Med Educ 2020, 20, 1–9, doi:10.1186/S12909-020-02386-W/TABLES/2.

Gowda, D.; Dubroff, R.; Willieme, A.; Swan-Sein, A.; Capello, C. Art as Sanctuary: A Four-Year Mixed-Methods Evaluation of a Visual Art Course Addressing Uncertainty through Reflection. Academic Medicine 2018, 93, S8–S13, doi:10.1097/ACM.0000000000002379.

Liou, K.T.; Jamorabo, D.S.; Geha, R.M.; Crawford, C.M.; George, P.; Schiffman, F.J. Foreign Bodies: Is It Feasible to Develop Tolerance for Ambiguity among Medical Students through Equine-Facilitated Learning? Med Teach 2019, 41, 960–962, doi:10.1080/0142159X.2019.1578876.

Taylor, D.; Picker, B.; Woolever, D.; Thayer, E.; Carney, P.; Galper, A. A Pilot Study to Address Tolerance of Uncertainty Among Family Medicine Residents. Fam Med 2018, 50, 531–538, doi:10.22454/FAMMED.2018.634768.

Bentwich, M.E.; Gilbey, P. More than Visual Literacy: Art and the Enhancement of Tolerance for Ambiguity and Empathy. BMC Med Educ 2017, 17, doi:10.1186/s12909-017-1028-7.

Masini, A. Equine-Assisted Psychotherapy in Clinical Practice. J Psychosoc Nurs Ment Health Serv 2010, 48, 30–34, doi:10.3928/02793695-20100831-08.

Taylor, D.A.; Picker, B.J.; Woolever, D.R.; Thayer, E.K.; Galper, A.B.; Carney, P.A. A Pilot Study to Address Tolerance of Uncertainty among Family Medicine Residents. Fam Med 2018, 50, 531–538, doi:10.22454/FamMed.2018.634768.

Patel, P.; Hancock, J.; Rogers, M.; Pollard, S.R. Improving Uncertainty Tolerance in Medical Students: A Scoping Review. Med Educ 2022, 56, 1163–1173.

Alam, R.; Cheraghi-Sohi, S.; Panagioti, M.; Esmail, A.; Campbell, S.; Panagopoulou, E. Managing Diagnostic Uncertainty in Primary Care: A Systematic Critical Review. BMC Fam Pract 2017, 18.

Almond, A.; Zou, Y.; Forbes, R. Navigating Diagnostic Uncertainty in Musculoskeletal Practice: The Perspectives and Experiences of New Graduate Physiotherapists. Musculoskelet Sci Pract 2021, 52, doi:10.1016/j.msksp.2021.102354.

Publicado
28-08-2023
Como Citar
Infante Guedes, A., Quintana Montesdeoca , M. del P., Etopa Bitata, M. D. P., & Álamo Arce, D. D. (2023). Estrategias educativas para la tolerancia a la incertidumbre en estudiantes y profesionales sanitarios: Revisión sistemática. Revista Espanhola de Educação Médica, 4(3). https://doi.org/10.6018/edumed.576711

Artigos mais lidos do(s) mesmo(s) autor(es)

Publication Facts

Metric
This article
Other articles
Peer reviewers 
3
2,4

Reviewer profiles  Indisp.

Author statements

Author statements
This article
Other articles
Data availability 
N/A
16%
External funding 
Indisp.
32%
Competing interests 
Indisp.
11%
Metric
This journal
Other journals
Articles accepted 
85%
33%
Days to publication 
52
145

Indexed in

Editor & editorial board
profiles
Academic society 
Universidad de Murcia
Publisher 
Ediciones de la Universidad de Murcia (Editum)