Fujikawa Hirohisa, Aoki Takuya, Ando Takayuki, Haruta Junji
Center for General Medicine Education, School of Medicine Keio University Shinjuku-ku Tokyo Japan.
Department of Medical Education Studies, International Research Center for Medical Education, Graduate School of Medicine The University of Tokyo Bunkyo-ku Tokyo Japan.
J Gen Fam Med. 2024 Oct 28;26(2):128-134. doi: 10.1002/jgf2.747. eCollection 2025 Mar.
Ambiguity tolerance in the clinical context is increasingly recognized as essential for physicians to work as professionals. However, the relationship between specialty and ambiguity tolerance in the clinical context has been understudied. Here, we investigated the association between specialty and ambiguity tolerance in the clinical context, focusing on differences between family physicians (FPs) and non-FPs.
We performed a nationwide cross-sectional study in Japan. We asked FPs from 14 family medicine residency programs across Japan and non-FPs from monitors of an internet survey company in Japan to participate in the study. We assessed their tolerance for ambiguity using the Japanese version of the Tolerance for Ambiguity in Medical Students and Doctors (J-TAMSAD) scale.
In total, 388 physicians (178 FPs and 210 non-FPs) completed our anonymous online survey and were included in the analysis. After adjustment for possible confounders (gender and postgraduate years), FPs had higher J-TAMSAD scale scores than internists/pediatricians, surgeons, and physicians with other specialties, meaning that FPs had greater ambiguity tolerance.
This study reveals that FPs had greater tolerance for ambiguity in the clinical context than non-FPs. Our findings suggest that there may be a need to increase non-FP's tolerance for ambiguity specific to the clinical context through educational interventions, since ambiguity is inherent and growing in medicine today. FPs and non-FPs should work together to complement each other's strengths, rather than simply improving the training of non-FPs.
在临床环境中,对模糊性的容忍度日益被视为医生作为专业人员开展工作的关键要素。然而,临床环境中专业与对模糊性的容忍度之间的关系尚未得到充分研究。在此,我们调查了临床环境中专业与对模糊性的容忍度之间的关联,重点关注家庭医生(FPs)与非家庭医生之间的差异。
我们在日本开展了一项全国性横断面研究。我们邀请了日本全国14个家庭医学住院医师培训项目的家庭医生以及日本一家互联网调查公司的非家庭医生参与研究。我们使用医学生和医生模糊性容忍度量表的日语版(J-TAMSAD)评估他们对模糊性的容忍度。
共有388名医生(178名家庭医生和210名非家庭医生)完成了我们的匿名在线调查并纳入分析。在对可能的混杂因素(性别和研究生年限)进行调整后,家庭医生的J-TAMSAD量表得分高于内科医生/儿科医生、外科医生以及其他专业的医生,这意味着家庭医生具有更高的模糊性容忍度。
本研究表明,在临床环境中,家庭医生比非家庭医生对模糊性具有更高的容忍度。我们的研究结果表明,由于当今医学中模糊性是固有的且不断增加,可能需要通过教育干预提高非家庭医生对临床环境特有的模糊性的容忍度。家庭医生和非家庭医生应携手合作,优势互补,而不是仅仅改善对非家庭医生的培训。