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      Ambiguity and uncertainty tolerance, need for cognition, and their association with stress. A study among Italian practicing physicians

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          ABSTRACT

          Medical practice is inherently ambiguous and uncertain. The physicians’ ability to tolerate ambiguity and uncertainty has been proved to have a great impact on clinical practice. The primary aim of the present study was to test the hypothesis that higher degree of physicians’ ambiguity and uncertainty intolerance and higher need for cognitive closure will predict higher work stress. Two hundred and twelve physicians (mean age = 42.94 years; SD = 10.72) from different medical specialties with different levels of expertise were administered a set of questionnaires measuring perceived levels of work-related stress, individual ability to tolerate ambiguity, stress deriving from uncertainty, and personal need for cognitive closure. A linear regression analysis was performed to examine which variables predict the perceived level of stress. The regression model was statistically significant [R 2 = .32; F(10,206) = 8.78, p ≤ .001], thus showing that, after controlling for gender and medical specialty, ambiguity and uncertainty tolerance, decisiveness (a dimension included in need for closure), and the years of practice were significant predictors of perceived work-related stress. Findings from the present study have some implications for medical education. Given the great impact that the individual ability to tolerate ambiguity and uncertainty has on the physicians’ level of perceived work-related stress, it would be worth paying particular attention to such a skill in medical education settings. It would be crucial to introduce or to empower educational tools and strategies that could increase medical students’ ability to tolerate ambiguity and uncertainty.

          Abbreviations: JSQ: Job stress questionnaire; NFCS: Need for cognitive closure scale; PRU: Physicians’ reactions to uncertainty; TFA: Tolerance for ambiguity

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          Most cited references50

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          Systematic review of depression, anxiety, and other indicators of psychological distress among U.S. and Canadian medical students.

          To systematically review articles reporting on depression, anxiety, and burnout among U.S. and Canadian medical students. Medline and PubMed were searched to identify peer-reviewed English-language studies published between January 1980 and May 2005 reporting on depression, anxiety, and burnout among U.S. and Canadian medical students. Searches used combinations of the Medical Subject Heading terms medical student and depression, depressive disorder major, depressive disorder, professional burnout, mental health, depersonalization, distress, anxiety, or emotional exhaustion. Reference lists of retrieved articles were inspected to identify relevant additional articles. Demographic information, instruments used, prevalence data on student distress, and statistically significant associations were abstracted. The search identified 40 articles on medical student psychological distress (i.e., depression, anxiety, burnout, and related mental health problems) that met the authors' criteria. No studies of burnout among medical students were identified. The studies suggest a high prevalence of depression and anxiety among medical students, with levels of overall psychological distress consistently higher than in the general population and age-matched peers by the later years of training. Overall, the studies suggest psychological distress may be higher among female students. Limited data were available regarding the causes of student distress and its impact on academic performance, dropout rates, and professional development. Medical school is a time of significant psychological distress for physicians-in-training. Currently available information is insufficient to draw firm conclusions on the causes and consequences of student distress. Large, prospective, multicenter studies are needed to identify personal and training-related features that influence depression, anxiety, and burnout among students and explore relationships between distress and competency.
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            Intolerance of ambiguity as a personality variable.

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              Individual differences in need for cognitive closure.

              This article introduces an individual-difference measure of the need for cognitive closure. As a dispositional construct, the need for cognitive closure is presently treated as a latent variable manifested through several different aspects, namely, desire for predictability, preference for order and structure, discomfort with ambiguity, decisiveness, and close-mindedness. This article presents psychometric work on the measure as well as several validation studies including (a) a "known-groups" discrimination between populations assumed to differ in their need for closure, (b) discriminant and convergent validation with respect to related personality measures, and (c) replication of effects obtained with situational inductions of the need for closure. The present findings suggest that the Need for Closure Scale is a reliable and valid instrument of considerable potential utility in future "motivated social cognition" research.
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                Author and article information

                Journal
                Med Educ Online
                Med Educ Online
                ZMEO
                zmeo20
                Medical Education Online
                Taylor & Francis
                1087-2981
                2017
                9 January 2017
                : 22
                : 1
                : 1270009
                Affiliations
                [ a ]Department of Psychology – Research Unit on Decision-making Processes in Emergency Medicine, Catholic University of the Sacred Heart , Milan, Italy
                [ b ]University of Milan, Department of Health Sciences , Milan, Italy
                Author notes
                CONTACT Paola Iannello paola.iannello@ 123456unicatt.it Department of Psychology, Catholic University of the Sacred Heart , Largo Gemelli, 1, Milan 20123, Italy
                Article
                1270009
                10.1080/10872981.2016.1270009
                5328324
                28178917
                4884a345-ecdd-4358-9aba-80c87a8ca85f
                © 2017 The Author(s). Published by Informa UK Limited, Taylor & Francis Group

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 6 July 2016
                : 30 November 2016
                : 19 October 2016
                Page count
                Tables: 4, References: 58, Pages: 10
                Categories
                Article
                Research Article

                Education
                tolerance for ambiguity,uncertainty,need for cognitive closure,work-related stress,medical expertise,practicing physicians

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