#2-38E. Cultivating Competence: Educational Strategies for Clinical Uncertainty (NEJM, 2025)

Do you ever feel a sense of doubt in your daily practice, asking yourself, "What is going on?" or "What should I do?" Clinical uncertainty is ubiquitous in medical practice, yet it is often viewed as a regrettable phenomenon to be tolerated or eradicated. This review argues that instead of avoiding uncertainty, teachers must reframe it as a central feature of clinical reasoning, recognizing that it cannot be eradicated even with advances in technology. The authors provide practical strategies for how experienced clinicians recognize and manage in-the-moment uncertainty, such as through forward planning and monitoring. The most crucial takeaway is that managing clinical uncertainty is a foundational skill for physicians, and teachers should reframe these experiences as signals for learning opportunities. This offers actionable insights for daily supervision, allowing clinicians to model effective uncertainty management. However, many of the proposed educational strategies, though grounded in psychology and education literatures, require empirical validation. This paper is essential for physician-educators, offering tools to enhance trainee confidence and instill generalizable lessons for complex clinical cases.

Citation: Ilgen JS, Dhaliwal G. Educational Strategies to Prepare Trainees for Clinical Uncertainty. New England Journal of Medicine. 2025. DOI: 10.1056/NEJMra2408797

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