[Tolerating uncertainty: Towards a competence-based approach].

Rev Med Interne

Service de médecine interne et immunologie clinique, CHU Nantes, Nantes, France; Faculté de médecine-pôle santé, Nantes Université, Nantes, France.

Published: January 2023

Uncertainty in inherent to every aspects of medical practice. As the concept of uncertainty in healthcare is still to explore, deciphering the determinants and the roots of this uncertainty would benefit from the insights of various disciplines, such as epistemology, sociology, mathematics, or philosophy. The urgent need to improve physician's ability to cope with uncertainty, has been recently highlighted by the COVID-19 pandemic. Besides, the concept of uncertainty tolerance has been proposed, and could serve as a relevant basis for approaching uncertainty, in medical education. Thus, we propose at first to discuss the uncertainty tolerance framework from Hillen et al. Then, from an educational perspective, we outline some avenues regarding how uncertainty tolerance could be thought, in a competence-based approach, and discuss several educational activities, which have proven efficient in promoting uncertainty tolerance among medical practitioners abroad.

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.revmed.2022.10.387DOI Listing

Publication Analysis

Top Keywords

uncertainty tolerance
16
uncertainty
9
concept uncertainty
8
[tolerating uncertainty
4
uncertainty competence-based
4
competence-based approach]
4
approach] uncertainty
4
uncertainty inherent
4
inherent aspects
4
aspects medical
4

Similar Publications

This paper proposes a hybrid stochastic-robust optimization framework for sizing a photovoltaic/tidal/fuel cell (PV/TDL/FC) system to meet an annual educational building demand based on hydrogen storage via unscented transformation (UT), and information gap decision theory-based risk-averse strategy (IGDT-RA). The hybrid framework integrates the strengths of UT for scenario generation and IGDT-RA (hybrid UT-IGDT-RA) for optimizing the system robustness and maximum uncertainty radius (MRU) of building energy demand and renewable resource generation. The deterministic model focuses on minimizing the cost of energy production over the project's lifespan (CEPLS) and considers a reliability constraint defined as the demand shortage probability (DSHP).

View Article and Find Full Text PDF

Introduction: Immune checkpoint inhibition has revolutionized the management of metastatic melanoma, including in the final stages of disease progression: because it is well tolerated, some teams do not discontinue it in hopes of slowing disease progression. The risks are that treatment may be continued unnecessarily, causing side effects, and reduce access to specialist palliative care, in addition to increasing the cost of treatment.

Method: We explored the experiences of 10 patients in a university hospital with metastatic melanoma under continued immune checkpoint inhibitors combined with specialist palliative care.

View Article and Find Full Text PDF

The determination of optimal production capacity for open-pit mines is influenced by various economic and technical factors and is highly susceptible to uncertainties. To effectively address the impact of uncertainty on capacity planning, this study develops a production capacity planning model for open-pit coal mines, based on the theory of economies of scale and incorporating multiple uncertainty constraints. A novel method is proposed to quantify and propagate the uncertainties of key capacity control factors, alongside a comprehensive uncertainty analysis framework for total revenue.

View Article and Find Full Text PDF

Lower body negative pressure (LBNP) has been used for decades in humans to model arterial baroreceptor unloading and represents a powerful tool for evaluating cardiovascular responses to orthostatic challenge. However, LBNP studies in animals have been limited to conditions of anesthesia or sedation, where cardiovascular reflexes are altered. Given the consequent uncertainties, the usefulness of LBNP studies in these preclinical models has been severely hampered.

View Article and Find Full Text PDF

Idiopathic Pulmonary Fibrosis (IPF) is a chronic respiratory disorder for which pirfenidone is the recommended first-line anti-fibrotic treatment. While pirfenidone has demonstrated efficacy in slowing the progression of IPF, its use is associated with several challenges and unresolved issues that impact patient outcomes. Pirfenidone administration can result in gastrointestinal side effects, photosensitivity reactions, and significant drug interactions, particularly in patients with hepatic impairment.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!