Mapping Uncertainty in Medicine

Mapping Uncertainty in Medicine
Author: Avril Danczak, Alison Lea, Geraldine Murphy
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If you experience uncertainty in clinical practice, this book will help you understand and manage it effectively, improving your stress levels and resilience as a result.

Uncertainty is the norm in medical practice, yet often gives rise to distress in clinicians who fear they will make shameful or guilt inducing errors.

This book offers a succinct method for classifying uncertainty and finding the right skills to manage different types of uncertainty successfully.

The psychology of uncertainty is explored in a way that gives rise to increased resilience as you learn to accept and manage uncertainty more proactively rather than fearing or denying it.

Uncertainty falls into distinct types:
• Analysing skills unpick uncertainties relating to diagnosis in the consultation.
• Networking skills are needed for effective use of diagnostic tests or referral pathways.
• Uncertainties in managing care will be helped by effective negotiating skills with individual patients or teamworking skills where a group, team or family is involved.

Uncertainty is normalised and contextualised to different aspects of daily practice. There is a simple algorithm, used to classify uncertainty and find the right skills for the particular problem. This method has been tried and tested with numerous groups and found to work well. The tool is also used to map effective methods for teaching and training on the subject of uncertainty.

Patient perspectives on uncertainty are also included.

ISBN Number: 9780850844054

Number of pages: 332

Publisher: RCGP

Published: March 2016

View table of contents

Part I Uncertainty in medicine
Thinking about uncertainty in medical practice
How to use this book

Part II Mapping uncertainty in medicine
The Analysing Quadrant
The Networking Quadrant
The Negotiating Quadrant
The Team-working Quadrant

Part III Mapping the psychology of uncertainty
The psychological themes that underpin clinicians’ responses to uncertainty
Mapping the psychology of uncertainty against the Analysing, Networking, Negotiating and Team-working Quadrants

Part IV Mapping uncertainty in medical training
Training clinicians to deal with uncertainty
Assessment using the Map of Uncertainty in Medicine
Educational methods for training for uncertainty
Educational skills for uncertainty in training
Learning about uncertainty

Part V Exploring uncertainty from the patient’s perspective
The impact of uncertainty on patients
Mapping uncertainty from the patient’s perspective

Author Bio

Dr Avril Danczak is a Manchester GP with extensive experience as a postgraduate and undergraduate educator, teaching general practice to medical students, Foundation Doctors and general practice trainees (Associates-in-Training). She also delivers ‘Train the Trainers’ courses for GP and Consultant educators, particularly Master Classes in Consultation Skills. Developing educational methods for medical training is a special interest.

Dr Alison Lea works in Tameside, Greater Manchester, as a GP, member of Tameside and Glossop Clinical Commissioning Group and was a clinical lecturer at the Academic Unit of Primary Care, University of Leeds, prior to moving into postgraduate medical education as a GP Training Programme Director. She is especially interested in learning and teaching clinical reasoning and decision making, working with clinicians at all levels of expertise.

Dr Geraldine Murphy is an Academic Clinical Fellow, currently in general practice training in Manchester. She is active in undergraduate teaching at the University of Manchester and in peer teaching of postgraduates. Her academic interests are focused around clinical reasoning and the use of new technology in teaching and learning.

Publisher reviews

“Certainty in medicine is an illusion, just as it is in everyday life. Keep this book by you – it will make sense of your uncertainties” - Amanda Howe in the foreword


Any clinician, whether experienced or in training

The book will help trainees prepare for Workplace Based Assessments and in clinical examinations:

• The RCGP curriculum includes explicit recommendations that part of the core competence of Managing Medical Complexity includes uncertainty, stating; "Deal with uncertainty and manage uncertainty, through retrieval of the best evidence available and communicate that uncertainty with safety netting".

• The RCP curriculum states that trainees must be able to discuss uncertainty with patients (Decision making and clinical reasoning section).

• The GMC makes numerous references to the need for doctors to deal with uncertainty effectively, including the sections on consent, accountability in teams, end of life care etc. This means that the management of uncertainty is part of the responsibility of every doctor registered with the GMC.

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Customer reviews and ratings (2)

Robert Stokes

Primary health care teams deal with uncertainty each day, usually without it intruding into consciousness. This book helped me classify and clarify the management of uncertainty in ways that I have never considered previously.

The algorithm has changed how I consider uncertainty - I commend the authors for a unique approach to this area of primary care. The book is relevant to everyone who consults in primary care.

Rob Stokes, GP Associate Dean, HEE.


A great book for personal learning and for use in teaching.

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