Approaches to teaching and assessing the communication of uncertainty in the health professions: a scoping review.

PURPOSE: Uncertainty is inherent to clinical practice and impacts diagnostic reasoning, patient safety, and trust. Despite its ubiquity, health professions education has not adequately prepared learners to communicate uncertainty to patients, families, and care teams. Training remains variable and unevenly assessed. The authors examined how uncertainty communication is taught and assessed across the health professions and identified gaps to inform curricular development and scholarship. METHOD: The authors conducted a scoping review guided by Arksey and O'Malley's framework and reported according to PRISMA-ScR guidelines. Eligible studies included learners from any health profession and addressed communication of uncertainty with patients and/or clinicians. Commentaries and reviews were excluded. Searches were conducted in PubMed, Ovid MEDLINE, Scopus, ERIC, CINAHL, and MedEdPORTAL beginning in March 2024 through August 2026. Data were analyzed using inductive and deductive analysis informed by Han's uncertainty taxonomy. Study quality was assessed using the Medical Education Research Study Quality Instrument (MERSQI). RESULTS: Searches identified 18,810 records. After screening, 213 full-text articles were reviewed and 21 were included in the final analysis. Most were conducted in the U.S. and published after 2019. Learners were predominantly physicians-in-training, with most studies focused on undergraduate and graduate medical education; fewer addressed continuing education or interprofessional learners. Diagnostic uncertainty was the most frequently addressed uncertainty type. Educational approaches were primarily experiential, including simulation, standardized patients, OSCEs, and role-playing. Fewer than half of studies involved patients in design, development, or assessment. Twenty studies assessed learners using self-reported surveys, faculty observations, or standardized patient evaluations. MERSQI scores ranged from 6.5 to 15.5 (mean 10.4). No study evaluated clinical practice or patient outcomes. CONCLUSIONS: Educational approaches to uncertainty communication are emerging but remain limited in scope, learner populations, and outcome evaluation. Future work should prioritize interprofessional, longitudinal curricula and rigorous assessment strategies linking education to clinical and patient-level outcomes.

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PubMed
Published
2026-10-28
DOI
https://doi.org/10.1093/acamed/wvag342
Primary Topic
Innovations in Medical Education
Type
article
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article

Approaches to teaching and assessing the communication of uncertainty in the health professions: a scoping review.

Lekshmi Santhosh, Abby L. Adamczyk, Janney Wale, Jessica M. Saunders et al.
1 links
PubMed
Innovations in Medical Education
article

Approaches to teaching and assessing the communication of uncertainty in the health professions: a scoping review.

Lekshmi Santhosh, Abby L. Adamczyk, Janney Wale, Jessica M. Saunders, Maria R. Dahm, Michael Pasirstein, Dimitrios Papanagnou, Ridhima Ghei, Paul Tominez, Abagayle Bierowski, Casey Morrone
article en

Abstract

PURPOSE: Uncertainty is inherent to clinical practice and impacts diagnostic reasoning, patient safety, and trust. Despite its ubiquity, health professions education has not adequately prepared learners to communicate uncertainty to patients, families, and care teams. Training remains variable and unevenly assessed. The authors examined how uncertainty communication is taught and assessed across the health professions and identified gaps to inform curricular development and scholarship. METHOD: The authors conducted a scoping review guided by Arksey and O'Malley's framework and reported according to PRISMA-ScR guidelines. Eligible studies included learners from any health profession and addressed communication of uncertainty with patients and/or clinicians. Commentaries and reviews were excluded. Searches were conducted in PubMed, Ovid MEDLINE, Scopus, ERIC, CINAHL, and MedEdPORTAL beginning in March 2024 through August 2026. Data were analyzed using inductive and deductive analysis informed by Han's uncertainty taxonomy. Study quality was assessed using the Medical Education Research Study Quality Instrument (MERSQI). RESULTS: Searches identified 18,810 records. After screening, 213 full-text articles were reviewed and 21 were included in the final analysis. Most were conducted in the U.S. and published after 2019. Learners were predominantly physicians-in-training, with most studies focused on undergraduate and graduate medical education; fewer addressed continuing education or interprofessional learners. Diagnostic uncertainty was the most frequently addressed uncertainty type. Educational approaches were primarily experiential, including simulation, standardized patients, OSCEs, and role-playing. Fewer than half of studies involved patients in design, development, or assessment. Twenty studies assessed learners using self-reported surveys, faculty observations, or standardized patient evaluations. MERSQI scores ranged from 6.5 to 15.5 (mean 10.4). No study evaluated clinical practice or patient outcomes. CONCLUSIONS: Educational approaches to uncertainty communication are emerging but remain limited in scope, learner populations, and outcome evaluation. Future work should prioritize interprofessional, longitudinal curricula and rigorous assessment strategies linking education to clinical and patient-level outcomes.

PubMed
Australian National University (AU), Thomas Jefferson University (US), Deakin University (AU), University of California, San Francisco (US), Tripler Army Medical Center (US), NYU Grossman Long Island School of Medicine (US), Wake Forest University Health Sciences (US), Wake Forest University (US), New York University (US)
Good health and well-being, Quality education
Openalex Percentile: Top 10%
Innovations in Medical Education
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