L. Ying1, R. Assi1, A. Harrington1, C. Thiessen1, M. Hubbard1, G. Nadzam1 1Yale University School Of Medicine,New Haven, CT, USA
Introduction: Due to ambiguities inherent to medical and surgical practice, a physicians’ intolerance for uncertainty (uncertainty intolerance, UI) can significantly impact the quality of their practice and their own mental well-being. Many residency programs, including our own, have introduced new education initiatives aimed at improving UI in our residents. However, currently there is no standard protocol to measure the effectiveness of such interventions, and there are no established methods for identifying the residents who would most benefit from the training. In this study, our goal is two-fold: 1. To validate the use of the Physician Reaction to Uncertainty (PRU) and Physician Risk Attitude (PRA) scales assessments for uncertainty intolerance, and 2. To determine if Myers-Briggs Type Indicator (MBTI) personality factors are associated with PRU and PRA scores and can be used to identify residents who are more likely to have higher UI.
Methods: The PRU and PRA scales, and the MBTI assessment were administered to a total pool of 71 general surgery residents. In addition to the survey questions, residents were asked to provide information regarding their gender (Male or Female), and stage of training (Junior or Senior).
Results: In total, 45 male residents and 25 female residents responded to the survey and completed the PRA and PRU scales (98.6%). There were no statistically significant differences found when comparisons were made between Junior versus Senior residents or Male versus Female residents. 37 male residents and 18 female residents also completed the MBTI assessment (80.4% and 72%, respectively). PRU and PRA scores were analyzed with respect to personality factors to determine if certain dichotomies are associated with increased uncertainty intolerance. Individuals identifying as Perceiving had significantly higher scores in the PRU category of “Concern about Bad Outcomes” (J: 8.76±3.39, P: 10.47±3.08; p<0.05), and on the PRA scale (J: 22.55±3.58, P: 20.71±2.34; p<0.05). Additionally, individuals identifying as Sensing had significantly higher scores on the PRU category of “Reluctance to Disclose Mistakes to Physicians” (S: 4.68±1.36, N: 3.74±2.40; p<0.05).
Conclusion: In this study, we have validated a new assessment for measuring the success of our education initiatives aimed at improving uncertainty tolerance. We found that the PRU and PRA assessments were simple to administer, and had a high completion rate due to buy-in from the residents. We have also demonstrated for the first time that specific personality factors are linked to higher uncertainty intolerance in surgical residents. These results will allow us to better identify residents who would benefit most from uncertainty intolerance training and to monitor their progress.