If I Quit in the Clinic and Do Nothing but Teach, I'm Going to Be Looking for a New Job: An Exploration of Uncertainty Management in Medical Education

Abstract

Academic medicine in the United States is a complex field, changing regularly in response to new healthcare knowledge, emerging technologies, and evolving funding models. Uncertainty management theory (UMT) provides scholars a lens to make sense of how individuals experience uncertainty. This study employs UMT to explore the experiences of clerkship and course directors (CDs), faculty in U.S. medical schools who serve in education administration roles. Fifteen semi-structured, in-depth interviews with eight CDs over 14 months indicate complicated relationships with uncertainty at work. Interpreted through UMT, these results reveal that some CDs manage uncertainty discursively, and at times, leverage uncertainty to maintain agency within their roles. These findings indicate that it may be important to recruit CDs who feel comfortable with and can manage uncertainty and provide them with appropriate socialization and ongoing support. Broadly, the results suggest that a more nuanced understanding of uncertainty management experiences can benefit both employees and institutions; as employees gain more role clarity, institutions receive information on how to better meet employees’ needs.