Evidence map›Paper›PMID 40325990›Full record

ReviewMedical education2025

Seeking medical wisdom: Development of a physician-defined practical model of wise competence.

Jordan Millhollin, Wei Wei Lee, Nic M Weststrate, Lars Osterberg, James N Woodruff

Abstract readReview
In one paragraph

Review in Medical education, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Jordan MillhollinIndiana University School of Medicine, Indianapolis, Indiana, USA.ORCID 0000-0002-6201-2555
Wei Wei LeeUniversity of Chicago Pritzker School of Medicine, Chicago, Illinois, USA.
Nic M WeststrateUniversity of Illinois Chicago, Chicago, Illinois, USA.
Lars OsterbergStanford University School of Medicine, Stanford, California, USA.ORCID 0000-0002-4694-837X
James N WoodruffUniversity of Chicago Pritzker School of Medicine, Chicago, Illinois, USA.ORCID 0000-0001-6050-820X

Funding

University of Chicago Pritzker School of Medicine
6 · The paper itself

Abstract

purposeMedical practice is complex, ambiguous and dynamic. It requires more than technical knowledge; it necessitates the application of wisdom. Unfortunately, integration of the wisdom construct into established U.S. medical competency frameworks has been difficult. This study explored this interdisciplinary problem by investigating how academic physicians define medical wisdom (MW) and discern barriers and facilitators to such integration.

methodInvestigators conducted in-depth, semi-structured interviews with 19 faculty physicians at 3 U.S. academic medical centres. They probed physicians' definitions of MW and perceived barriers and facilitators to the development of MW. Interview data were analysed using thematic analysis (TA). TA results and insights from non-medical models of wisdom and complex problem-solving supported the creation of a model of MW. Polarity mapping of the moral economies of medical wisdom and medical science was utilized to clarify the challenges and opportunities of integrating these two philosophically distinct paradigms.

resultsTA of transcripts suggests physicians understand MW as consisting of interactions between 3 core components: adaptive capacity, values and technical knowledge. This finding and insights on their integration derived from non-medical models of wisdom supported the creation of a tripartite model of medical wisdom (TMMW) with features of complex adaptive systems (CAS). Polarity mapping of the moral economies of medical wisdom and medical science highlighted differences in assumptions, values and practices between the two paradigms. Barriers and facilitators identified through TA reinforced the relevance of these differences to difficulties in incorporating wisdom into established medical competency frameworks.

conclusionsWise competence is the ability to integrate medical knowledge with clinical context and patient wishes to deliver patient-centered care. The TMMW offers a mental model of such integration with features of CAS and a critical role for metacognition. Introduction of MW models into established competency frameworks may benefit from explicit acknowledgement of each paradigm's underlying moral economies.

Indexed as

Clinical CompetencePhysiciansFaculty, MedicalFemaleHumansInterviews as TopicMaleProblem SolvingQualitative ResearchUnited States

Identifiers

PMID40325990
PMCPMC12355642

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Registered trials

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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.