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Authors
Abstract(s)
Introdução
A incerteza é um aspeto intrínseco e inevitável da prática clínica que influencia os
pensamentos, emoções e ações dos médicos. Lidar com este aspeto da prática clínica tem se
tornado cada vez mais desafiador tendo em conta a evolução dos cuidados de saúde.
Considerando os potenciais efeitos causados pela baixa tolerância à incerteza, é importante
cultivar o seu aumento. No entanto, a incerteza raramente é abordada nos currículos
médicos. Uma ferramenta importante para avaliar a tolerância à incerteza é a escala
Tolerance of Ambiguity in Medical Students and Doctors Scale, que foi desenvolvida para
avaliar a tolerância à ambiguidade em estudantes de medicina e médicos recém-formados,
e foi a escolhida neste trabalho para atingir os principais objetivos. A escala foi traduzida
para português e validada para avaliar a preparação para lidar com a incerteza nos
estudantes de Medicina do 2º e 5º ano da Faculdade de Ciências da Saúde da Universidade
da Beira Interior, com objetivo final de identificar possíveis áreas de melhoria do currículo
médico atual.
Métodos
A versão portuguesa da escala foi obtida através das seguintes etapas: tradução da escala
original, comparação e síntese das versões traduzidas, retrotradução, comparação das
retrotraduções, pré-teste, análise do pré-teste e obtenção da versão final da escala. A
aplicação da escala foi feita em formato digital aos estudantes de medicina do 2º e 5º anos
da Faculdade de Ciências da Saúde da Universidade da Beira Interior seguida da análise
estatística dos dados obtidos. A análise estatística incluiu uma análise fatorial exploratória
e testes para avaliação da fiabilidade interna da escala. Para além disso as pontuações
obtidas pelos estudantes foram classificadas em alta, mediana, ou baixa tolerância à
incerteza, foram realizadas estatísticas descritivas para as mesmas pontuações e testes-t
independentes para explorar a possível influência de características dos estudantes na
pontuação obtida na escala.
Resultados e discussão
A análise fatorial exploratória e os coeficientes alfa de Cronbach e ômega de McDonald
revelaram um modelo com 3 fatores e demonstraram a validade e fiabilidade da escala
traduzida. Foi encontrada uma relação significativa entre frequentar o ensino superior pela primeira vez e a pontuação obtida na escala. Apesar de não se ter identificado uma diferença
significativa entre as pontuações dos estudantes do 2º e 5º anos de medicina, os estudantes
numa fase mais avançada do percurso curricular, apresentaram, em média, pontuações
superiores, podendo sugerir que a tolerância à incerteza é um traço mutável, modificável
com a experiência. Verificou-se que os estudantes em análise têm uma tolerância à incerteza
superior à encontrada noutros trabalhos, possivelmente em correlação com o currículo
médico com maior componente prático desta faculdade.
Conclusão
Em termos gerais, os resultados sugerem que, no que diz respeito à incerteza na prática
clínica, a amostra em estudo revelou ter em média uma tolerância à incerteza superior à das
amostras analisadas noutros países. Ainda assim, poderão ser considerados ajustes no
currículo médico desta faculdade, contribuindo para uma melhor preparação dos
estudantes de medicina para lidar com a incerteza na prática clínica futura
Os resultados indicaram, ainda, que a escala traduzida possui boas propriedades
psicométricas, sendo considerada válida e fiável. Não obstante ser necessário dar sequência
ao estudo exploratório agora realizado, o presente instrumento revela potencial e poderá
ser utilizado em investigações futuras, permitindo uma investigação mais aprofundada do
tema, assim como auxiliar no desenvolvimento e melhoria do currículo médico em Portugal.
Introduction Uncertainty is an intrinsic and inevitable aspect of clinical practice that influences doctors' thoughts, emotions and actions. Dealing with this aspect of clinical practice has become increasingly challenging given the evolution of healthcare. Considering the potential effects caused by low tolerance to uncertainty, it is important to cultivate its increase. However, uncertainty is rarely addressed in the medical curriculum. An important tool for assessing uncertainty tolerance is the Tolerance of Ambiguity in Medical Students and Doctors Scale, developed to assess tolerance to ambiguity in medical students and newly graduated doctors and was chosen in this work. to achieve the main objectives. The scale was translated to Portuguese and validated to assess the preparedness to deal with uncertainty in 2nd and 5 th year medical students of the Faculty of Health Sciences of University of Beira Interior, with the ultimate goal of identifying areas for improvement in the current medical curriculum. Methods The Portuguese version of the scale was obtained through the following steps: forward translation, comparison and synthesis of the translated versions, back-translation, comparison of back-translations, pre-testing, pre-test analysis and obtention of the final version of the translated scale. The scale was applied in a digital format to medical students in the 2nd and 5th years of the Faculty of Health Sciences of University of Beira Interior followed by statistical analysis of the obtained data. Statistical analysis included an exploratory factor analysis and tests to assess the internal reliability of the scale. Furthermore, the scores obtained by the students were classified as high, average, or low uncertainty tolerance. Descriptive statistics were performed for the same scores and independent t-tests were performed to explore the possible influence of student characteristics on the score obtained. Results and discussion Exploratory factor analysis and Cronbach's alpha and McDonald's omega revealed a model with 3 factors and demonstrated the validity and reliability of the translated scale. A significant relationship was found between attending higher education for the first time and the score obtained on the scale. Although a significant difference was not identified between the scores of students in the 2nd and 5th years of medicine, students at a more advanced stage of the curricular path presented, on average, higher scores, which may suggest that uncertainty tolerance is a changeable trait, modifiable with experience. It was found that the students analyzed had a higher uncertainty tolerance than what was found in other studies, possibly in correlation with the medical curriculum with a greater practical component of this faculty. Conclusion In general terms, the results suggest that, regarding uncertainty in the clinical practice, the sample under analysis revealed, on average, to have a higher uncertainty tolerance than samples analyzed in other countries. Still, adjustments to the medical curriculum of this faculty could be considered, contributing to a better preparation of medical students to deal with uncertainty in future clinical practice. The results also indicated that the translated scale has good psychometric properties and is considered valid and reliable. Despite the need to continue the exploratory study now carried out, this instrument reveals potential and could be used in future research, allowing for a more in-depth investigation of the topic, as well as assisting in the development and improvement of the medical curriculum in Portugal.
Introduction Uncertainty is an intrinsic and inevitable aspect of clinical practice that influences doctors' thoughts, emotions and actions. Dealing with this aspect of clinical practice has become increasingly challenging given the evolution of healthcare. Considering the potential effects caused by low tolerance to uncertainty, it is important to cultivate its increase. However, uncertainty is rarely addressed in the medical curriculum. An important tool for assessing uncertainty tolerance is the Tolerance of Ambiguity in Medical Students and Doctors Scale, developed to assess tolerance to ambiguity in medical students and newly graduated doctors and was chosen in this work. to achieve the main objectives. The scale was translated to Portuguese and validated to assess the preparedness to deal with uncertainty in 2nd and 5 th year medical students of the Faculty of Health Sciences of University of Beira Interior, with the ultimate goal of identifying areas for improvement in the current medical curriculum. Methods The Portuguese version of the scale was obtained through the following steps: forward translation, comparison and synthesis of the translated versions, back-translation, comparison of back-translations, pre-testing, pre-test analysis and obtention of the final version of the translated scale. The scale was applied in a digital format to medical students in the 2nd and 5th years of the Faculty of Health Sciences of University of Beira Interior followed by statistical analysis of the obtained data. Statistical analysis included an exploratory factor analysis and tests to assess the internal reliability of the scale. Furthermore, the scores obtained by the students were classified as high, average, or low uncertainty tolerance. Descriptive statistics were performed for the same scores and independent t-tests were performed to explore the possible influence of student characteristics on the score obtained. Results and discussion Exploratory factor analysis and Cronbach's alpha and McDonald's omega revealed a model with 3 factors and demonstrated the validity and reliability of the translated scale. A significant relationship was found between attending higher education for the first time and the score obtained on the scale. Although a significant difference was not identified between the scores of students in the 2nd and 5th years of medicine, students at a more advanced stage of the curricular path presented, on average, higher scores, which may suggest that uncertainty tolerance is a changeable trait, modifiable with experience. It was found that the students analyzed had a higher uncertainty tolerance than what was found in other studies, possibly in correlation with the medical curriculum with a greater practical component of this faculty. Conclusion In general terms, the results suggest that, regarding uncertainty in the clinical practice, the sample under analysis revealed, on average, to have a higher uncertainty tolerance than samples analyzed in other countries. Still, adjustments to the medical curriculum of this faculty could be considered, contributing to a better preparation of medical students to deal with uncertainty in future clinical practice. The results also indicated that the translated scale has good psychometric properties and is considered valid and reliable. Despite the need to continue the exploratory study now carried out, this instrument reveals potential and could be used in future research, allowing for a more in-depth investigation of the topic, as well as assisting in the development and improvement of the medical curriculum in Portugal.
Description
Keywords
Competências Médicas Educação Médica Estudantes de Medicina Incerteza Clínica Prática Clínica