“Thinking Out Loud” and “Pivoting on the Fly”—An Empirical Review and Critical Incident Study of How Physicians Engage in Incidental Learning Amidst Complexity

ABSTRACT This study explores incidental learning among physicians navigating uncertainty during the COVID‐19 pandemic. Using a constructivist research design, we conducted a literature review of 13 empirical studies on incidental learning in complexity and analyzed critical incident interviews with 12 emergency medicine and intensive care physicians, using a combined deductive‐inductive coding approach. We illustrate how incidental learning in complexity operates through five key tensions: evidence‐based protocols versus intuitive responses, instability versus stability‐seeking, individual expertise versus collaborative input, professional confidence versus acknowledged vulnerability, and cognitive demands versus emotional management. Physicians employed strategies including “thinking out loud” to convert tacit insights into actionable knowledge, pattern recognition under ambiguous conditions, and collaborative cross‐checking to navigate patient care without established protocols. These findings challenge existing process models of incidental learning by demonstrating non‐linear, tension‐driven forms of learning. The study contributes to HRD theory by revealing how incidental learning functions as an accelerator for innovative thinking and adaptive decision making when traditional evidence‐based approaches prove insufficient.