Simulation-based education's impact on medical students' tolerance of uncertainty: A grounded theory study

The purpose of this grounded study was to explore how medical students encountered and managed uncertainty during a high-fidelity simulation. We interviewed 15 fourth year medical students as they progressed through the scenario and used constant comparative analysis to analyze our interview data. Three themes emerged from our data, which informed our theoretical framework: 1) Uncontrollable circumstances were the root of uncertainty; 2) uncertainty drove unhelpful responses evident in self and team; and 3) enhanced tolerance of uncertainty developed through cognitive restructuring and collaboration. Understanding how medical students successfully manage uncertainty during a high-fidelity simulation provides valuable insights for medical educators aiming to intentionally support and enhance students' uncertainty tolerance. Encouraging students to employ techniques such as cognitive restructuring and fostering social support during simulation can be valuable strategies for preparing them for the challenges of uncertainty in their future medical careers.