Evidence map›Paper›PMID 40525296›Full record

ArticleMedical education2025

Tolerance of ambiguity and psychological wellbeing in newly qualified doctors: An analysis over multiple time points.

Jason Hancock, Obioha C Ukoumunne, Bryan Burford, Gillian Vance, Thomas Gale, Karen Mattick

Abstract read
In one paragraph

Article in Medical education, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Strategies for Teaching Uncertainty Tolerance in Medical Education: A Qualitative Study.Journal of the American College of Emergency Physicians open · 2026
    Article
  2. Article
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

6 authors.

Jason HancockHealth Professionals Education and Wellbeing Research Group, Department of Health and Community Sciences, Faculty of Health and Life Sciences, University of Exeter, UK.ORCID 0000-0002-6342-9555
Obioha C UkoumunneNIHR Applied Research Collaboration South West Peninsula (PenARC), Department of Health and Community Sciences, Faculty of Health and Life Sciences, University of Exeter, UK.ORCID 0000-0002-0551-9157
Bryan BurfordMedical Education, School of Medicine, Newcastle University, UK.ORCID 0000-0003-4687-7556
Gillian VanceMedical Education, School of Medicine, Newcastle University, UK.
Thomas GaleMedical Education, Collaboration for the Advancement of Medical Education Research, Peninsula Medical School, University of Plymouth, UK.ORCID 0000-0003-4551-5860
Karen MattickHealth Professionals Education and Wellbeing Research Group, Department of Health and Community Sciences, Faculty of Health and Life Sciences, University of Exeter, UK.ORCID 0000-0003-1800-773X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThere is evidence of an association between tolerance of ambiguity and psychological wellbeing in doctors, but this relationship is not well understood. We explored this relationship, and the individual or workplace factors moderating it, in a population of newly qualified doctors.

methodsWe examined the experiences of newly qualified doctors in the UK as they started a novel interim role (Time 1) and later moved into foundation year 1 roles (Times 2 and 3) during the COVID-19 pandemic. Doctors completed the Tolerance of Ambiguity of Medical Students and Doctors scale (TAMSAD Range: 0-100), the Perceived Stress Scale (PSS: 0-40), the Hospital Anxiety and Depression Scale (HADS: 0-21) and the Copenhagen Burnout Inventory (CBI: 0-100), over four months. Cross-sectional and longitudinal relationships between tolerance of ambiguity (TAMSAD) and wellbeing outcomes (PSS, HADS, CBI) were examined and potential moderators (age, gender, recent change in working environment) were explored.

resultsA total of 451 participants completed the survey at Time 1, 214 at Time 2, 172 at Time 3. Higher tolerance of ambiguity was associated with lower levels of stress (regression coefficient: -0.09, R2 = 1.6%, p = 0.008), anxiety (-0.06, R2 = 1.6%, p = 0.009), depression (-0.03, R2 = 1.1%, p = 0.03) and workplace burnout (-0.40, R2 = 3.9%, p < 0.001) at Time 1. It was associated with lower levels of anxiety (-0.08, R2 = 2.4%, p = 0.03) at Time 2 and stress (-0.16, R2 = 3.4%, p = 0.02) at Time 3. Individual factors (being over 25 years, being female) and workplace factors (not moving location) seemed to strengthen the relationship between tolerance of ambiguity and psychological wellbeing.

conclusionThere appears to be a longitudinal relationship between lower tolerance of ambiguity and reduced psychological wellbeing in early career doctors within the UK. This study emphasises the importance of supporting all graduating doctors to navigate clinical ambiguity however further research is needed outside of the context of COVID-19.

Indexed as

COVID-19PhysiciansStudents, MedicalAdultAnxietyBurnout, ProfessionalCross-Sectional StudiesDepressionFemaleHumansLongitudinal StudiesMaleMental HealthSARS-CoV-2Stress, PsychologicalSurveys and Questionnaires

Identifiers

PMID40525296
PMCPMC12438002

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.