Implicit expression of uncertainty in medical students during different sequences of clinical reasoning in simulated patient handovers
Background: Dealing with medical uncertainty is an essential competence of physicians. During handovers, communication of uncertainty is important for patient safety, but is often not explicitly expressed and can hamper medical decisions. This study examines medical students’ implicit expression of...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | deu |
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German Medical Science GMS Publishing House
2023-02-01
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| Series: | GMS Journal for Medical Education |
| Subjects: | |
| Online Access: | http://www.egms.de/static/en/journals/zma/2023-40/zma001589.shtml |
| _version_ | 1811162370150498304 |
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| author | Harendza, Sigrid Bacher, Hans Jakob Berberat, Pascal O. Kadmon, Martina Gärtner, Julia |
| author_facet | Harendza, Sigrid Bacher, Hans Jakob Berberat, Pascal O. Kadmon, Martina Gärtner, Julia |
| author_sort | Harendza, Sigrid |
| collection | DOAJ |
| description | Background: Dealing with medical uncertainty is an essential competence of physicians. During handovers, communication of uncertainty is important for patient safety, but is often not explicitly expressed and can hamper medical decisions. This study examines medical students’ implicit expression of uncertainty in different sequences of clinical reasoning during simulated patient handovers.Methods: In 2018, eighty-seven final-year medical students participated in handovers of three simulated patient cases, which were videotaped and transcribed verbatim. Sequences of clinical reasoning and language references to implicit uncertainty that attenuate and strengthen information based on a framework were identified, categorized, and analyzed with chi-square goodness-of-fit tests.Results: A total of 6358 sequences of clinical reasoning were associated with the four main categories , and , with statements occurring significantly (p<0.001) most frequently. Attenuated sequences of clinical reasoning occurred significantly (p<0.003) more frequently than strengthened sequences. Implications were significantly more often attenuated than strengthened (p<0.003). Statements regarding results occurred significantly more often plain or strengthened than statements regarding actions (p<0.0025).Conclusion: Implicit expressions of uncertainty in simulated medical students’ handovers occur in different degrees during clinical reasoning. These findings could contribute to courses on clinical case presentations by including linguistic terms and implicit expressions of uncertainty and making them explicit. |
| first_indexed | 2024-04-10T06:28:27Z |
| format | Article |
| id | doaj.art-65044ab74bde482bb73d2d97b2f87e1e |
| institution | Directory Open Access Journal |
| issn | 2366-5017 |
| language | deu |
| last_indexed | 2024-04-10T06:28:27Z |
| publishDate | 2023-02-01 |
| publisher | German Medical Science GMS Publishing House |
| record_format | Article |
| series | GMS Journal for Medical Education |
| spelling | doaj.art-65044ab74bde482bb73d2d97b2f87e1e2023-03-01T13:10:11ZdeuGerman Medical Science GMS Publishing HouseGMS Journal for Medical Education2366-50172023-02-01401Doc710.3205/zma001589Implicit expression of uncertainty in medical students during different sequences of clinical reasoning in simulated patient handoversHarendza, Sigrid0Bacher, Hans Jakob1Berberat, Pascal O.2Kadmon, Martina3Gärtner, Julia4Universitätsklinikum Hamburg-Eppendorf, III. Medizinische Klinik, Hamburg, GermanyUniversitätsklinikum Hamburg-Eppendorf, III. Medizinische Klinik, Hamburg, GermanyTechnische Universität München, Fakultät für Medizin, TUM Medical Education Center, München, GermanyUniversität Augsburg, Medizinische Fakultät, Dekanat, Augsburg, GermanyUniversitätsklinikum Hamburg-Eppendorf, III. Medizinische Klinik, Hamburg, GermanyBackground: Dealing with medical uncertainty is an essential competence of physicians. During handovers, communication of uncertainty is important for patient safety, but is often not explicitly expressed and can hamper medical decisions. This study examines medical students’ implicit expression of uncertainty in different sequences of clinical reasoning during simulated patient handovers.Methods: In 2018, eighty-seven final-year medical students participated in handovers of three simulated patient cases, which were videotaped and transcribed verbatim. Sequences of clinical reasoning and language references to implicit uncertainty that attenuate and strengthen information based on a framework were identified, categorized, and analyzed with chi-square goodness-of-fit tests.Results: A total of 6358 sequences of clinical reasoning were associated with the four main categories , and , with statements occurring significantly (p<0.001) most frequently. Attenuated sequences of clinical reasoning occurred significantly (p<0.003) more frequently than strengthened sequences. Implications were significantly more often attenuated than strengthened (p<0.003). Statements regarding results occurred significantly more often plain or strengthened than statements regarding actions (p<0.0025).Conclusion: Implicit expressions of uncertainty in simulated medical students’ handovers occur in different degrees during clinical reasoning. These findings could contribute to courses on clinical case presentations by including linguistic terms and implicit expressions of uncertainty and making them explicit.http://www.egms.de/static/en/journals/zma/2023-40/zma001589.shtmlassessmentcommunicationcompetencesimulationhandoveruncertainty |
| spellingShingle | Harendza, Sigrid Bacher, Hans Jakob Berberat, Pascal O. Kadmon, Martina Gärtner, Julia Implicit expression of uncertainty in medical students during different sequences of clinical reasoning in simulated patient handovers GMS Journal for Medical Education assessment communication competence simulation handover uncertainty |
| title | Implicit expression of uncertainty in medical students during different sequences of clinical reasoning in simulated patient handovers |
| title_full | Implicit expression of uncertainty in medical students during different sequences of clinical reasoning in simulated patient handovers |
| title_fullStr | Implicit expression of uncertainty in medical students during different sequences of clinical reasoning in simulated patient handovers |
| title_full_unstemmed | Implicit expression of uncertainty in medical students during different sequences of clinical reasoning in simulated patient handovers |
| title_short | Implicit expression of uncertainty in medical students during different sequences of clinical reasoning in simulated patient handovers |
| title_sort | implicit expression of uncertainty in medical students during different sequences of clinical reasoning in simulated patient handovers |
| topic | assessment communication competence simulation handover uncertainty |
| url | http://www.egms.de/static/en/journals/zma/2023-40/zma001589.shtml |
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