Do family physicians develop ambiguity tolerance as they gain experience? A multicenter cross-sectional study

Area of Science:

• Medical Education
• Physician Well-being
• Healthcare Professionals

Background:

• Ambiguity tolerance is crucial for optimal patient care and physician well-being.
• Previous research indicated higher ambiguity tolerance in family physicians compared to non-family physicians.
• The developmental trajectory of ambiguity tolerance in family physicians remained unclear.

Purpose of the Study:

• To investigate the relationship between the number of postgraduate years (PGYs) and ambiguity tolerance in family physicians.
• To explore associations between PGYs, ambiguity tolerance, burnout, and work engagement.
• To understand when ambiguity tolerance develops during family medicine residency.

Main Methods:

• A nationwide cross-sectional study was conducted with 173 family physicians across 14 Japanese residency programs.
• Ambiguity tolerance was measured using the Japanese version of the Tolerance for Ambiguity in Medical Students and Doctors scale.
• Burnout and work engagement were assessed using validated Japanese scales.

Main Results:

• Family physicians with 7 or more postgraduate years (PGY ≥7) demonstrated significantly higher ambiguity tolerance compared to those with 3-6 PGYs.
• Physicians in the PGY ≥7 group also exhibited a lower risk of burnout.
• Work engagement was significantly higher in physicians with 7-20 PGYs compared to those with 3-6 PGYs.

Conclusions:

• Family medicine residents may experience vulnerability during their training but can develop increased ambiguity tolerance and well-being over time.
• Residency program supervisors should assess and optimize learning environments to support trainee development.
• The findings highlight the importance of considering the duration of postgraduate training in relation to physician competency and well-being.