2023/02/15 by Sigrid Harendza, Harendza, Sigrid, Hans Jakob Bacher +7
Health Professions · Medicine · #Assessment #Clinical Reasoning and Diagnostic Skills #Hospital Admissions and Outcomes #Kommunikation #Kompetenz #Medicine and health #Patient Safety and Medication Errors #Simulation #Unsicherheit #assessment #communication #competence #handover #simulation #uncertainty #Übergabe
paper · doi:10.3205/zma001589
openalex publication_date 2023/02/15 · openalex created_date 2025/10/10 · openalex updated_date 2026/08/01
Background: Dealing with medical uncertainty is an essential competence of physicians. During handovers, communication of uncertainty is important for patient safety, but is often not explicitly expressed and can hamper medical decisions. This study examines medical students' implicit expression of uncertainty in different sequences of clinical reasoning during simulated patient handovers. Methods: In 2018, eighty-seven final-year medical students participated in handovers of three simulated patient cases, which were videotaped and transcribed verbatim. Sequences of clinical reasoning and language references to implicit uncertainty that attenuate and strengthen information based on a framework were identified, categorized, and analyzed with chi-square goodness-of-fit tests. Results: , with statements occurring significantly (p<0.001) most frequently. Attenuated sequences of clinical reasoning occurred significantly (p<0.003) more frequently than strengthened sequences. Implications were significantly more often attenuated than strengthened (p<0.003). Statements regarding results occurred significantly more often plain or strengthened than statements regarding actions (p<0.0025). Conclusion: Implicit expressions of uncertainty in simulated medical students' handovers occur in different degrees during clinical reasoning. These findings could contribute to courses on clinical case presentations by including linguistic terms and implicit expressions of uncertainty and making them explicit.