Echoes of the Uncanny: Evaluating Tolerance for Ambiguity and Reflective Capacity in Medical Students and Residents

Larry Laufman – Baylor College of Medicine

Abstract: Evidence-based medicine has produced treatment algorithms for many illnesses, yet uncertainty and ambiguity still permeate healthcare delivery. Healthcare professionals with lower tolerance for ambiguity (TFA) are more likely to order unnecessary tests, avoid patients with complex medical issues, and experience psychological distress. Residents and students with low TFA may be at higher risks for burnout. Medical educators recognize the importance of improving TFA and reflective capacity, yet methods for achieving these outcomes have yet to fully incorporate the visual arts.

Previous research has shown that visual arts programming can have a positive effect on reflective capacity. Healthcare professionals who have developed reflective capacity consider the emotional and cognitive impacts of their decisions, evaluate those decisions objectively, and apply this analysis to future situations. Improvements in reflective capacity through visual art observation may lead to higher TFA.

Using a mixed-methods approach, we compared the impact on tolerance for ambiguity and reflective capacity of a museum-based program involving two different groups of learners: medical students and residents. Through group discussions, drawing exercises, and other activities, learners developed visual observation and communication skills while reflecting on how to apply these skills to clinical scenarios involving ambiguity. Overall, we found that these activities positively impacted tolerance for ambiguity and reflective capacity among residents and students. We will present the results from this pilot study and discuss strategies for incorporating the visual arts into medical education.

Keywords: visual arts in medical education, tolerance for ambiguity, reflective capacity