Types of uncertainty

  • Teacher 
  • Patient 
  • Doctor/Registrar


  • Knowledge 
  • Diagnosis 
  • Management 
  • Treatment 
  • Agenda (overt/hidden) 
  • Shared Uncertainty - with patient
  • Resources 
    • Can we implement plans?
  • Business 
    • Organisation 
    • Finance

Concept of the 'safety-net' is essential

Uncertainty in the doctor depends on several aspects 

  • Knowledge 
  • Support 
  • Confidence
  • How much uncertainty can we tolerate? 
  • Use of time 
  • Overkill (too many tests, etc.)

Dealing with uncertainty

Example: dealing with scenario of 12 year old girl with discharge


  1. Support mechanism - the Registrar must be aware what support is available and how to access it.
    This should be provided when the Registrar arrives at the practice so they can know what is available and how to access it.
  2. Recognition of limitations.
  3. Recognition of 'key triggers'.
  4. Identify minimum competency/strategy.
  5. Acknowledge uncertainty and share it.
    This is an integral part of dealing with a Registrar's uncertainty. It is important for them to appreciate we all have uncertainty within consultations. The difference is more experienced doctors are better able to cope with this uncertainty and have a high threshold before distance appears. Factors which influence this are knowledge, skills, experience, etc.

Aspects to consider when teaching


Coping with uncertainty