Navigating Uncertainty in Medicine through Storytelling and Hands-On Learning

When clinicians poorly communicate their uncertainty about a particular medical test, treatment, or diagnosis, it can lead to misunderstandings that can jeopardize the safety of their patients. Despite this, there is a lack of established curricula and reliable assessment methods to teach clinicians how to accept uncertainty as a regular part of clinical practice – and effectively communicate about it.

To help fill this gap, the ABIM Foundation, the Gordon and Betty Moore Foundation, and the Josiah Macy Jr. Foundation have awarded $360,000 to support three innovative projects that are taking complementary approaches to help clinicians process and communicate more effectively about uncertainty, and thereby improve trust between them and their patients.

"The ability to communicate uncertainty in treatment or in response to patient questions is a critical skill for medical professionals," said Richard J. Baron, MD, President and CEO of the American Board of Internal Medicine and the ABIM Foundation. "These projects will play a pivotal role in equipping clinicians with the tools they need to navigate complex scenarios while maintaining transparency and trust."

Among other things, the Building Trustworthiness by Addressing Uncertainty in Medicine grant program will fund the creation of a new curriculum on addressing uncertainty for medical students and trainees, a library of resources for communicating about uncertainty that will be available to all users at no cost, and a 6-part podcast series on uncertainty that can reach busy practicing clinicians.

Through the program, the sponsors hope to enhance patient safety, clinician satisfaction, and trusting relationships within the clinical team and between clinicians and patients.

"Real-world medicine is filled with uncertainty," said Karen Crosby, Program Director of the Diagnostic Excellence Initiative with the Gordon and Betty Moore Foundation. "The Moore Foundation is pleased to support these innovative projects to help healthcare professionals acknowledge, manage, and communicate uncertainty."
The funded projects include:

A multidisciplinary team of experts from the Sidney Kimmel Medical College at Thomas Jefferson University, the University of California – San Francisco, and the Australian National University will create a repository of existing resources and assessments focused on communicating about uncertainty in clinical settings, develop new training and assessment materials to supplement and connect the resources identified in the repository, and support a learning ecosystem by pilot testing the materials for different audiences at multiple training sites.</li>

The Kaiser Permanente Bernard J. Tyson School of Medicine will create a competency-based curriculum to teach learners the knowledge, skills and attitudes they need to communicate effectively about uncertainty. It will include hands-on learning methods to help medical students and trainees communicate and collaborate with patients and with clinicians from across the care team.

Arts Practica, a medical education consultancy, and The Nocturnists, an award-winning medical storytelling program, will create and disseminate a six-episode podcast series. "Uncertainty in Medicine" will blend storytelling, conversation and education to provide a provocative listening experience that will help clinicians better handle uncertainty.

Each program will receive $120,000. Projects will equip clinicians with the tools they need to navigate the permutations of medical uncertainty and contribute to a shift in how clinicians approach and communicate about the complexities inherent to their role.

"Navigating ambiguity and uncertainty is a fraught but frequent challenge in the clinical environment, but is crucial in sustaining trusting relationships within teams and with patients and families," said Holly J. Humphrey, MD, MACP, president of the Josiah Macy Jr. Foundation. "The Josiah Macy Jr. Foundation is delighted to partner with the ABIM Foundation and the Gordon and Betty Moore Foundation to support these innovative projects to help learners and physicians gain the skills they need to meet this challenge."

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About the ABIM Foundation
The ABIM Foundation's mission is to advance medical professionalism to improve the health care system by collaborating with physicians and physician leaders, medical trainees, health care delivery systems, payers, policymakers, consumer organizations and patients to foster a shared understanding of professionalism and how they can adopt the tenets of professionalism in practice. To learn more about the ABIM Foundation, visit www.abimfoundation.org and connect on LinkedIn.

About the Gordon and Betty Moore Foundation
The Gordon and Betty Moore Foundation fosters path-breaking scientific discovery, environmental conservation, patient care improvements and preservation of the special character of the Bay Area. Visit www.moore.org or follow @MooreFound.

About the Josiah Macy Jr. Foundation
Since 1930, the Josiah Macy Jr. Foundation has worked to improve health care in the United States. Founded by Kate Macy Ladd in memory of her father, prominent businessman Josiah Macy Jr., the Foundation supports projects that broaden and improve health professional education. It is the only national foundation solely dedicated to this mission. Visit the Macy Foundation at macyfoundation.org and follow on Twitter at @macyfoundation.