Medical students’ responses to uncertainty: a cross-sectional study using a new self-efficacy questionnaire in Aotearoa New Zealand

OBJECTIVES: Responding well to clinical uncertainty is a crucial skill for any doctor. To better understand how medical students develop this skill, Social Cognitive Theory can be used to explore students’ perceived capability to respond to situations of uncertainty. This study aimed to construct a self-efficacy questionnaire and use it to measure medical students’ responses to clinical uncertainty. DESIGN: A 29-item questionnaire was constructed. For each item, participants rated their confidence in responding to uncertain situations using a scale of 0–100. Data were analysed with descriptive and inferential statistics. SETTING: Aotearoa New Zealand. PARTICIPANTS: The questionnaire was distributed to 716 of 852 medical students in second, fourth and sixth year, at the three campuses of the Otago Medical School. RESULTS: The Self-Efficacy to Respond to Clinical Uncertainty (SERCU) questionnaire was completed by 495 participants (69% response rate) and found to be highly reliable (α=0.93). Exploratory factor analysis confirmed a unidimensional scale. A multiple linear regression model predicted self-efficacy scores from year of study, age, mode of entry, gender and ethnicity, F(11,470) = 4.252, p<0.001 adj. R²=0.069. Male students and those admitted to the programme 3 years postdegree or with significant allied health experience were predicted to have significantly higher self-efficacy scores. Year of study was not a significant predictor of average efficacy scores. CONCLUSIONS: Our research contributes a novel, highly reliable questionnaire that uses self-efficacy to measure medical student responses to uncertainty. The questionnaire revealed that students’ confidence in responding to uncertainty may be more related to their background and life experience than to progression through the curriculum. Medical educators and researchers can use the SERCU questionnaire to obtain a new perspective on how their students respond to uncertainty, inform future research and tailor teaching about uncertainty.