Approaches to teaching and assessing the communication of uncertainty in the health professions: a scoping review.
Publication/Presentation Date
10-28-2026
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.
ISSN
1938-808X
Published In/Presented At
Papanagnou, D., Dahm, M. R., Adamczyk, A., Saunders, J., Wale, J., Tominez, P., Bierowski, A., Ghei, R., Morrone, C., Pasirstein, M., & Santhosh, L. (2026). Approaches to teaching and assessing the communication of uncertainty in the health professions: a scoping review. Academic medicine : journal of the Association of American Medical Colleges, wvag342. Advance online publication. https://doi.org/10.1093/acamed/wvag342
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
42949089
Department(s)
Administration and Leadership
Document Type
Article