SynthesisMedical education2020
Tolerance of ambiguity and psychological well-being in medical training: A systematic review.
Synthesis in Medical education, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 72 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
72 citing papers in PubMed, 3 syntheses or guidelines pooled it, 204 citations in OpenAlex.
- Moderators uncertainty tolerance (UT) in healthcare: a systematic review.Advances in health sciences education : theory and practice · 2023Pooled it
- Art Interventions to Mitigate Burnout in Health Care Professionals: A Systematic Review.The Permanente journal · 2023Pooled it
- Tolerance of ambiguity and psychological well-being in medical training: A systematic review.Medical education · 2020Pooled it
- Facing uncertainty in primary care: perceptions, strategies and educational needs - a qualitative explorative study with German general practice trainees.BMC medical education · 2026Article
- Tolerance of uncertainty and reflection ability among medical students in Germany.BMC medical education · 2026Article
- 'I was a bit hasty … I was a young resident!' Medical residents' responses to clinical uncertainty.Medical education · 2026Article
- The Effects of Integrating Visual Thinking Strategies on Intellectual Humility, Tolerance of Ambiguity, Empathy, and Observation Skills: A pre-post Study among Medical Students.Medical science educator · 2026Article
- Global gaps in how we assess undergraduate medical students' mental health: a scoping review protocol.BMJ open · 2026Article
- First-year residents' experiences of uncertainty in rural and urban emergency departments.BMC medical education · 2026Article
- New Graduate Nurses' Experiences of Decision-Making Uncertainty in Intensive Care: An Interpretive Description.Nursing in critical care · 2026Article
- Uncertainty tolerance in healthcare: towards a normative conception.Theoretical medicine and bioethics · 2026Article
- Factors Influencing the Multicultural Competence of Occupational Therapists in South Korea.Occupational therapy international · 2026Article
- Development and Validation of the Chinese Physicians' Reactions to Uncertainty Scale for Endoscopy: A Mixed-Methods Approach.Canadian journal of gastroenterology & hepatology · 2026Article
- Development and early reach of a podcast-based innovation to support medical residents' personal and professional development.Medical education online · 2025Article
- Clinical Reasoning Uncertainty in Veterinary Medical Encounters with a Clinical Example.Veterinary sciences · 2025Review
- The potential of uncertainty tolerance measures to identify specific needs of first-year medical residents: an exploratory study.BMC medical education · 2025Article
- Clinicians' tolerance for uncertainty and communication about uncertainty with older adults -a standardized patient assessment study.BMC geriatrics · 2025Observational
- Understanding clinical ambiguity in family medicine: Implications for training and global practice.Journal of general and family medicine · 2025Article
- Postgraduate GPs' experience of attending medical uncertainty training during the standardised training of residents: a qualitative process evaluation.BMC medical education · 2025Article
- Uncertainty experienced by newly qualified doctors during the transition to internship.Medical education · 2025Article
12 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
contextThe prevalence of stress, burnout and mental health disorders in medical students and doctors is high. It has been proposed that there may be an association between levels of tolerance of ambiguity (ie an ability to tolerate a lack of reliable, credible or adequate information) in clinical work and psychological well-being within this population. The aims of this systematic review were: (i) to assess the nature and extent of the literature available, in order to determine if there is an association, and (ii) to develop a conceptual model proposing possible mechanisms to underpin any association, in order to inform subsequent research.
methodsMEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PsycINFO databases were searched for articles published from inception to September 2018. Additional literature was identified by searching the reference lists of included articles, forward searches of included articles, hand searches of key journals and a grey literature search. Of the 671 studies identified, 11 met the inclusion criteria. A qualitative synthesis of included studies was performed.
resultsAll 11 included studies reported an association between a lower level of tolerance of ambiguity or uncertainty and reduced psychological well-being. Included studies were heterogeneous in terms of population and measurement approach, and were often of low methodological quality. Subsets of items from previously developed scales were often used without sufficient consideration of the impact of new combinations of items on scale validity. Similar scales were also scored inconsistently between studies, making comparison difficult.
conclusionsThere appears to be an association between tolerance of ambiguity and psychological well-being. This provides new opportunities to understand and prevent the development of stress, burnout and mental health disorders in medical students and doctors. The conceptual model developed provides a framework for future research, which we hope will prevent wasted research effort through duplication and promote higher methodological quality.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.