"It's Okay to Say 'I Don't Know'": Medical Students Use Transformative Thinking to Cope with Ambiguity and Uncertainty

Abstract

Uncertainty refers to the internal tension of not fully knowing or understanding a situation and is a concept that physicians must learn to deal with in order to become an effective provider. Ambiguity refers to the situation that is not fully known. Mezirow proposed that transformative learning occurs in response to a "disorienting dilemma" during which the students' frames of reference are challenged. We used his model to explain how clerkship students learn to cope with ambiguity and uncertainty. We analyzed third year medical students reflective practice essays for encounters with clinical uncertainty and ambiguity and examined how they reacted to these dilemmas. Our study is unique in its robust data set which included 273 essays.

Keywords

• transformative learning
• uncertainty
• ambiguity
• Mezirow
• medical student education