Abstract
Introduction: Uncertainty tolerance (UT), a construct describing individuals’ responses to uncertainty, is considered highly relevant to healthcare practice. Unfortunately, the existing research focused on measuring UT is inconsistent between studies and across measures. To help unravel UT measurement ambiguities, this study asked ‘What is the evidence for the reliability and validity of healthcare-specific UT measures?’
Methods: This study evaluated healthcare UT measures administered to medical professionals and/or students with provision of evidence for reliability and validity. Four research databases were searched for eligible studies. A rubric following published psychometrics principles was used to extract study features, reliability coefficients, and validity evidence. A meta-analysis of Cronbach’s alphas was conducted. A meta-regression evaluated the influence of UT scales and population types on the summary outcome.
Results: Thirty-six studies met inclusion criteria. Four measures appeared in at least four included studies: Physicians’ Reactions to Uncertainty 1990 (PRU1990) and 1995 (PRU1995), Tolerance for Ambiguity (TFA), and Tolerance of Ambiguity in Medical Students and Doctors (TAMSAD). The meta-analysis revealed an acceptable aggregated internal consistency across all measures (0.77). Per the meta-regression, aggregated alphas for each UT scale ranged from good (PRU1990 0.83) to poor (TAMSAD 0.69), and were higher for doctors (0.78) than for medical students (0.70). Validity evidence was most prevalent for concurrent and predictive validity, and weakest for response processes.
Discussion: No UT measure had a fully comprehensive validity argument. The lack of evidence for response processes suggests the way participants conceptualise the UT construct is unclear, and given population differences in reliability, may differ between students and experts.
Conclusions: Currently, the reliability and validity evidence for UT measures in medical student populations is inadequate. We caution against using these measures for high stakes applications pending further research (e.g. clarifying response processes using think-aloud protocols).
Methods: This study evaluated healthcare UT measures administered to medical professionals and/or students with provision of evidence for reliability and validity. Four research databases were searched for eligible studies. A rubric following published psychometrics principles was used to extract study features, reliability coefficients, and validity evidence. A meta-analysis of Cronbach’s alphas was conducted. A meta-regression evaluated the influence of UT scales and population types on the summary outcome.
Results: Thirty-six studies met inclusion criteria. Four measures appeared in at least four included studies: Physicians’ Reactions to Uncertainty 1990 (PRU1990) and 1995 (PRU1995), Tolerance for Ambiguity (TFA), and Tolerance of Ambiguity in Medical Students and Doctors (TAMSAD). The meta-analysis revealed an acceptable aggregated internal consistency across all measures (0.77). Per the meta-regression, aggregated alphas for each UT scale ranged from good (PRU1990 0.83) to poor (TAMSAD 0.69), and were higher for doctors (0.78) than for medical students (0.70). Validity evidence was most prevalent for concurrent and predictive validity, and weakest for response processes.
Discussion: No UT measure had a fully comprehensive validity argument. The lack of evidence for response processes suggests the way participants conceptualise the UT construct is unclear, and given population differences in reliability, may differ between students and experts.
Conclusions: Currently, the reliability and validity evidence for UT measures in medical student populations is inadequate. We caution against using these measures for high stakes applications pending further research (e.g. clarifying response processes using think-aloud protocols).
| Original language | English |
|---|---|
| Pages | 185 |
| Number of pages | 1 |
| Publication status | Published - 2021 |
| Event | Australian & New Zealand Association for Health Professional Educators Conference 2021 - virtual conference Duration: 6 Jul 2021 → 17 Jul 2021 https://eventstudio.eventsair.com/anzahpe-2021/ https://anzahpe.org/2021-conference https://az659834.vo.msecnd.net/eventsairaueprod/production-eventstudio-public/ca97935aae4a4c068cb7b8a58e22df45 (Abstract Book) |
Conference
| Conference | Australian & New Zealand Association for Health Professional Educators Conference 2021 |
|---|---|
| Abbreviated title | ANZAHPE 2021 |
| City | virtual conference |
| Period | 6/07/21 → 17/07/21 |
| Other | ANZAHPE Festival 2021 Theme: Moving forward in ambiguity |
| Internet address |