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探索在经历不确定情况时谦逊的存在及其作用。

Exploring the presence and roles of humility when experiencing situations of uncertainty.

作者信息

Michalec Barret, Papanagnou Dimitrios, Raj Leela, Lundgren Henriette, Watkins Karen E, Marsick Victoria J, Ziring Deborah, Vaid Urvashi

机构信息

Center for Advancing Interprofessional Education, Practice and Research Edson College of Nursing and Health Innovation, Arizona State University Phoenix Arizona USA.

Department of Emergency Medicine, Sidney Kimmel Medical College Thomas Jefferson University Philadelphia Pennsylvania USA.

出版信息

AEM Educ Train. 2025 Jan 20;9(1):e11055. doi: 10.1002/aet2.11055. eCollection 2025 Feb.

Abstract

BACKGROUND

Uncertainty is a pervasive challenge in clinical practice. Whereas the importance of humility in navigating uncertainty has been discussed, empirical research on how humility is practiced or expressed (i.e., humility in action) is lacking. This study examines humility's presence and role in physicians' uncertainty experiences during the COVID-19 pandemic. The objectives were to determine if and how humility presented in physicians' reflections on uncertain situations during the height of the COVID-19 pandemic and to explore potential roles of humility in managing uncertainty.

METHODS

After intercoder reliability was established, four members of the author team utilized qualitative data analysis software to conduct a secondary analysis of critical incident interviews with 12 physicians (seven ED and five ICU physicians) about experiences with uncertainty while caring for COVID-19 patients. To identify if humility was present in situations of uncertainty, the authors deductively coded transcripts for key elements of humility based on previously published conceptualizations by Tangney (2000) and Gruppen (2015). Additionally, the authors examined code co-occurrence to identify clusters of humility and conducted a thematic analysis to uncover potential roles of humility and what humility "looks like" in clinical situations.

RESULTS

Aspects of humility were frequently present in physicians' narratives. Acknowledgment of shortcomings was most common. Acceptance of limitations, openness, and perspective-taking frequently co-occurred. Two key themes emerged: humility allowed physicians to trust their training despite uncertainty and enabled pivoting and adapting to new information.

CONCLUSIONS

Findings suggest that humility facilitates managing uncertainty by promoting trust in abilities and enabling flexibility and openness. Formal training in humility may better prepare clinicians for uncertainty. Further research should explore nuances of humility across clinical situations and types of uncertainty.

摘要

背景

不确定性是临床实践中普遍存在的挑战。虽然已经讨论了谦逊在应对不确定性中的重要性,但关于谦逊如何实践或表达(即实际行动中的谦逊)的实证研究却很缺乏。本研究考察了谦逊在新冠疫情期间医生应对不确定性经历中的存在情况及其作用。目的是确定在新冠疫情高峰期医生对不确定情况的反思中谦逊是否存在以及如何存在,并探讨谦逊在管理不确定性中的潜在作用。

方法

在建立编码员间信度后,作者团队的四名成员使用定性数据分析软件,对12名医生(7名急诊科医生和5名重症监护室医生)就其在照顾新冠患者时应对不确定性的经历进行的关键事件访谈进行二次分析。为了确定在不确定情况下是否存在谦逊,作者根据Tangney(2000年)和Gruppen(2015年)先前发表的概念化内容,对访谈记录进行演绎编码,以找出谦逊的关键要素。此外,作者还检查了编码共现情况以识别谦逊的聚类,并进行了主题分析以揭示谦逊的潜在作用以及谦逊在临床情况下“是什么样子”。

结果

谦逊的各个方面在医生的叙述中经常出现。最常见的是对缺点的承认。接受局限性、开放态度和换位思考经常同时出现。出现了两个关键主题:谦逊使医生在面对不确定性时信任自己的培训,并能够灵活应对和适应新信息。

结论

研究结果表明,谦逊通过促进对自身能力的信任以及实现灵活性和开放性来帮助管理不确定性。谦逊方面的正式培训可能会让临床医生更好地应对不确定性。进一步的研究应探索不同临床情况和不确定性类型下谦逊的细微差别。

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