To do or not to do: Teaching the skill of deciding what to do in the face of uncertainty.

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The management of uncertainty is a coregeneral practice skill best learnt in clinical practice. This article outlines strategies a general practice supervisor can implement to help registrars acquire the skills of managing and coping with uncertainty. The medical education literature recommends supervisors being explicit about the different paradigm operating in primary care and normalising the existence and tolerance of uncertainty. Fundamental consultation skills used in the management of uncertainty should bedemonstrated. These include shared decision making, safety netting and arranging follow-up. During teaching sessions, problem cases can be explored using Murtagh's diagnostic model to develop clinical reasoning and avoid missing important diagnoses. This paper introduces a model to explore uncertainty by considering management options, easily remembered as the '3Rs': review; refer; and Rx (treat). This model complements the diagnostic model and reflects that a general practitioner must still decide what to do when a diagnosis cannot be made.