Reflecting on Uncertainty Tolerance in Student Pharmacists Following an Inpatient Rounding Simulation: A Pilot Mixed-Methods Study.

BACKGROUND

With increasing involvement of pharmacists in clinical situations and expanding scope of practice, the expectation and management of uncertainty is a desirable component of pharmacy education, leading to improved uncertainty tolerance (UT) as pharmacists.

METHODS

The purpose of this pilot study was to determine whether an inpatient rounding simulation (IRS) that exposes student pharmacists to a level of uncertainty leads to changes in tolerance of ambiguity scale (TAS) scores and self-reflection comments. A pre-/post-observational, pilot survey study was conducted, including student pharmacists in their second professional year at the United States School of Pharmacy who were enrolled in an associated lab-based course in Spring 2024. Student teams completed a mock IRS and responded to clinical questions in a timed environment. Students completed pre-/post-simulation TAS and self-reflection on uncertainty/UT within the simulation. Pre-/post-simulation TAS scores were analyzed with a paired -test. Qualitative analysis was used to identify themes in self-reflection.

RESULTS

59 students responded (48% response rate). TAS was not different pre-/post-IRS (63.2 vs. 62.6, = 0.63). When individual subscales were compared, a statistically significant difference was found in the insolubility subscale (10.5 vs. 9.5; = 0.02). Themes of uncertainty that emerged during qualitative analysis of pre-simulation included the clinical question posed to the team. Student pharmacists overcame uncertainty pre-simulation by working with their team and relying on the availability of resources. Themes of uncertainty emerging during qualitative analysis of post-simulation included discerning the best answer. Student pharmacists overcame uncertainty post-simulation by working with their team and cited working with their team as a positive aspect of the IRS experience.

CONCLUSIONS

In this pilot study, student pharmacists had high TAS scores both pre- and post-simulation. Students utilized their teams and cited this as a positive in an uncertain environment.