RCSI Health Professions' Education Centre, 123 St Stephen's Green, Dublin, Ireland.
School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.
Adv Health Sci Educ Theory Pract. 2021 Aug;26(3):913-958. doi: 10.1007/s10459-021-10028-z. Epub 2021 Mar 1.
Although the evidence base around uncertainty and education has expanded in recent years, a lack of clarity around conceptual terms and a heterogeneity of study designs means that this landscape remains indistinct. This scoping review explores how undergraduate health professions' students learn to engage with uncertainty related to their academic practice. To our knowledge, this is the first scoping review which examines teaching and learning related to uncertainty across multiple health professions. The scoping review is underpinned by the five-stage framework of (Arksey and O'Malley in Scoping studies: Towards a methodological framework International Journal of Social Research Methodology 8(1) 19-32, 2005). We searched MEDLINE, Embase, PsychINFO, ISI Web of Science, and CINAHL and hand-searched selected health professions' education journals. The search strategy yielded a total of 5,017 articles, of which 97 were included in the final review. Four major themes were identified: "Learners' interactions with uncertainty"; "Factors that influence learner experiences"; "Educational outcomes"; and, "Teaching and learning approaches". Our findings highlight that uncertainty is a ubiquitous concern in health professions' education, with students experiencing different forms of uncertainty at many stages of their training. These experiences are influenced by both individual and system-related factors. Formal teaching strategies that directly support learning around uncertainty were infrequent, and included arts-based teaching, and clinical case presentations. Students also met with uncertainty indirectly through problem-based learning, clinical teaching, humanities teaching, simulation, team-based learning, small group learning, tactical games, online discussion of anatomy topics, and virtual patients. Reflection and reflective practice are also mentioned as strategies within the literature.
尽管近年来不确定性和教育方面的证据基础有所扩大,但由于概念术语缺乏清晰度以及研究设计的异质性,这一领域仍然不明确。本范围综述探讨了本科医疗保健专业学生如何学习应对与学术实践相关的不确定性。据我们所知,这是首次审查检查不确定性在多个健康专业领域的教学和学习的范围综述。该范围综述以(Arksey 和 O'Malley 在范围研究中的五阶段框架:迈向方法框架,国际社会研究方法杂志 8(1)19-32,2005)为基础。我们在 MEDLINE、Embase、PsychINFO、ISI Web of Science 和 CINAHL 中进行了搜索,并对选定的健康专业教育期刊进行了手工搜索。搜索策略共产生了 5017 篇文章,其中 97 篇被纳入最终综述。确定了四个主要主题:“学习者与不确定性的互动”;“影响学习者体验的因素”;“教育成果”;和,“教学方法”。我们的研究结果表明,不确定性是健康专业教育中普遍存在的问题,学生在培训的许多阶段都经历着不同形式的不确定性。这些经历受到个人和系统相关因素的影响。直接支持不确定性学习的正式教学策略很少,包括基于艺术的教学和临床病例介绍。学生还通过基于问题的学习、临床教学、人文教学、模拟、团队学习、小组学习、战术游戏、在线讨论解剖主题和虚拟患者间接地遇到不确定性。文献中还提到了反思和反思实践作为策略。