Abstract
BackgroundMedicine is a field that is simultaneously factual and ambiguous. Medical students have their first exposure to full time clinical practice during clerkship. While studies have examined medical trainees’ tolerance of ambiguity (TOA), the extent to which TOA is affected by clinical experiences and its association with perfectionism is unknown. The aim of this study was to evaluate the effect of clerkship experience on TOA and perfectionism in medical students.MethodsThis was a multiple sampling, single cohort study of students in their first year of clinical clerkship which is comprised of 6 core rotations. Consenting students completed an online anonymous survey assessing their tolerance of ambiguity (TOA) and perfectionism in their first (pre) and last (post) 12 weeks of their clinical clerkship year. Tolerance of Ambiguity in Medical Students and Doctors (TAMSAD) and The Big Three perfectionism scale-short form (BTPS-SF) were used to assess TOA and perfectionism respectively. Pre-Post mean comparisons of TOA and perfectionism were assessed via t-tests.ResultsFrom a cohort of 174 clinical clerkship students, 51 students responded to pre-survey, 62 responded to post-survey. Clerkship was associated with a significant decrease in TOA (p < 0.00) with mean pre-TOA scores of 59.57 and post TOA of 43.8. Perfectionism scores were not significantly different over time (p > 0.05). There was a moderate inverse correlation between TOA and perfectionism before clerkship (r = 0.32) that increased slightly after clerkship (r = 0.39). Those preferring primary care specialties had significantly lower rigid and total perfectionism scores in pre-clerkship than those choosing other specialties, but this difference was not found post-clerkship.ConclusionExposure to clerkship decreased TOA while perfectionism remained stable in medical students. These results were not expected as exposure has been previously shown to increase TOA. The frequency of rotation changes maintaining a cycle of anxiety may be an underlying factor accounting for these results. Overall these results require further investigation to better characterize the role of clinical exposure on TOA.
Highlights
Medicine is a field that is simultaneously factual and ambiguous
Both tolerance of ambiguity and perfectionism are personality traits that vary across all persons, but not frequently researched in the context of medical education and are the focus of this study [3,4,5]
The aim of this study was guided by three research questions: 1) To what extent does relationship exist between tolerance of ambiguity (TOA) and perfectionism for medical students in their first year of clerkship? 2) How does clerkship modify these factors and/or their relationship? 3) Are perfectionism and TOA related to a student’s specialty choice?
Summary
Medicine is a field that is simultaneously factual and ambiguous Medical students have their first exposure to full time clinical practice during clerkship. The final years of medical school, known as the clerkship years, are typically comprised of medical students getting first-hand experience in various medical fields This serves a two-fold purpose: to create a comprehensive foundation of medical knowledge and to expose them to possible specialization career choices. Different medical specializations and contexts may potentially be better suited to certain personality traits Both tolerance of ambiguity and perfectionism are personality traits that vary across all persons, but not frequently researched in the context of medical education and are the focus of this study [3,4,5]
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