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Identifying validity evidence for uncertainty tolerance scales: A systematic review
Georgina C Stephens1, Michelle D Lazarus2, Mahbub Sarkar3
1Centre for Human Anatomy Education, Monash University, Clayton, Victoria, Australia.
Medical Education
|December 28, 2022
Summary
Validity evidence for uncertainty tolerance (UT) scales in medical education is limited. The PRU1990 and PRU1995 scales show the most promise, but further research is needed, especially regarding response processes and testing consequences.
Area of Science:
- Medical Education Research
- Psychometrics
- Healthcare Professional Development
Background:
- Uncertainty tolerance (UT) is a critical attribute for medical graduates.
- Existing UT scales are widely used but lack comprehensive validity evidence summaries.
- This study addresses the need to evaluate the psychometric properties of commonly used UT scales.
Approach:
- A systematic literature search identified psychometric studies of four major UT scales (PRU1990, PRU1995, TFA, TAMSAD) in physicians and medical students.
- Studies were analyzed based on the Standards for Educational and Psychological Testing framework, focusing on five sources of validity evidence.
- Included studies were rated for evidence related to test content, response processes, internal structure, relations to other variables, and consequences of testing.
Key Points:
- Evidence for 'relations to other variables' and 'internal structure' was most frequently reported.
- No studies provided evidence for 'response processes' or 'consequences of testing'.
- The PRU1990 and PRU1995 scales exhibited the strongest validity evidence, primarily within physician populations.
Conclusions:
- No single UT scale demonstrated evidence across all five validity sources.
- Future research should focus on 'response processes' and 'consequences of testing' in diverse medical learner and physician groups.
- Caution is advised against using UT scales for high-stakes decisions until more robust validity evidence is established.
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