Yale School of Medicine, New Haven, Connecticut.
Yale School of Medicine, New Haven, Connecticut.
J Surg Res. 2020 Jan;245:145-152. doi: 10.1016/j.jss.2019.07.035. Epub 2019 Aug 13.
Physicians are frequently called on to make medical decisions despite being uncertain about the outcomes of these choices. The psychological stress associated with these dilemmas, known as "Uncertainty Intolerance" (UI), can significantly impact the quality of a physician's practice as well as their own mental health. Coping with uncertainty is an important competency that all residents must master, and some residency programs are introducing new education initiatives aimed at improving UI. However, currently there is no standard protocol for measuring UI or the effectiveness of such interventions and there are no established methods for identifying the residents who would most benefit from the training. In this study, we aim to use the Physician Reaction to Uncertainty (PRU) and Physician Risk Attitude (PRA) scales as assessments for UI in surgical residents, and to determine if Myers-Briggs Type Indicator (MBTI) personality factors are associated with PRU and PRA scores and can be used to identify residents who are more likely to have higher UI.
The PRU and PRA scales, and the MBTI assessment were administered to a total pool of 71 general surgery residents. In addition to the survey questions, residents provided information regarding their gender (male or female), and stage of training (junior or senior).
In total, 45 male residents and 25 female residents completed the PRA and PRU scales (98.6%). There were no statistically significant differences when comparisons were made between junior and senior residents or male and female residents. Thirty seven male residents and 18 female residents also completed the MBTI assessment (80.4% and 72%, respectively). PRU and PRA scores were analyzed with respect to personality factors to determine if certain dichotomies are associated with increased UI. There was a trend toward higher UI in individuals identifying with Judging.
In this study, we have conducted a pilot study using the PRU and PRA scales to measuring the success of our new education initiatives aimed at improving uncertainty tolerance. We found that the PRU and PRA assessments were simple to administer and had a high completion rate. Our findings also suggest that individuals who identify with Judging may better tolerate the uncertainties associated with surgical practice, although larger studies will be required to determine if MBTI factors are linked to UI in surgical residents.
尽管医师对这些选择的结果不确定，但他们经常需要做出医疗决策。与这些困境相关的心理压力被称为“不确定性容忍度”（UI），这会极大地影响医师的实践质量和他们自己的心理健康。应对不确定性是所有住院医师必须掌握的重要能力，一些住院医师培训计划正在引入新的教育计划，旨在提高 UI。然而，目前尚无测量 UI 的标准方案，也没有评估这些干预措施效果的既定方法，也没有确定最需要培训的住院医师的方法。在这项研究中，我们旨在使用医师对不确定性的反应（PRU）和医师风险态度（PRA）量表来评估外科住院医师的 UI，并确定 Myers-Briggs 类型指标（MBTI）人格因素是否与 PRU 和 PRA 分数相关，以及是否可以用于识别更有可能出现较高 UI 的住院医师。
共向 71 名普通外科住院医师发放了 PRU 和 PRA 量表以及 MBTI 评估。除了调查问题外，住院医师还提供了有关其性别（男性或女性）和培训阶段（初级或高级）的信息。
共有 45 名男性住院医师和 25 名女性住院医师完成了 PRA 和 PRU 量表（98.6％）。在初级和高级住院医师或男性和女性住院医师之间进行比较时，没有统计学上的显着差异。37 名男性住院医师和 18 名女性住院医师也完成了 MBTI 评估（分别为 80.4％和 72％）。分析了 PRU 和 PRA 分数与人格因素的关系，以确定某些二分法是否与 UI 增加相关。具有判断特征的个体表现出更高 UI 的趋势。
在这项研究中，我们使用 PRU 和 PRA 量表进行了一项试点研究，以衡量我们旨在提高不确定性容忍度的新教育计划的成功。我们发现 PRU 和 PRA 评估易于管理，并且完成率很高。我们的研究结果还表明，具有判断特征的个体可能更好地承受与外科实践相关的不确定性，尽管需要进行更大规模的研究才能确定 MBTI 因素是否与外科住院医师的 UI 相关。
