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Towards Embracing Clinical Uncertainty

Lessons from Social Work, Optometry and Medicine

University of Waterloo, Canada, mspaffor{at}uwaterloo.ca

Catherine F. Schryer

University of Waterloo, Canada

Sandra L. Campbell

University of Waterloo, Canada

Lorelei Lingard

University of Toronto, Canada

• Summary: The oral transmission and transformation of client information in an apprenticeship setting provides a rich environment in which to observe students and their expert supervisors managing uncertainty. In this Canadian-based study, we examined the communicative features of 12 social work supervisions involving social work students and their supervisors and enriched our observations with subsequent interviews of the participants.

• Findings: Social work students viewed the acknowledgement and examination of uncertainty as a touchstone of competent social work. This observation contrasted with our past study of medical and optometry students who focused on personal deficit and a distrust of acknowledging uncertainty. Our observations and interviews revealed a unique professional signature to the novice rhetoric of uncertainty (seeking guidance, deflecting criticism, owning limits, showing competence) that suggests differing professional identities and contextual settings.

• Applications : An attitudinal shift toward accepting and trusting uncertainty in medicine and optometry may facilitate an enriched educational environment for students and a more open dialogue with patients about uncertainty. The unique professional signatures of this rhetoric offer insights into how professional identity shapes attitudes and behaviors toward uncertainty and suggest a source of tension within interdisciplinary healthcare teams.

Key Words: case presentation • optometry and medicine • professional identity • social work supervision • uncertainty

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