Work in Progress: Jeffrey Krimmel-Morrison

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Work in Progress: Jeffrey Krimmel-Morrison

May 24 @ 12:00 pm - 1:00 pm

Work in Progress with 2021-2022 CLIME Grantee Jeffrey Krimmel-Morrison

“How Physicians Navigate Clinical Uncertainty in Primary Care”

Jeffrey Krimmel- Morrison, MD


Bjorn Watsjold, MD, MPH, Department of Emergency Medicine, University of Washington

Gabrielle Berger, MD, Department of Medicine, University of Washington

Glenn Regehr, PhD, Department of Surgery, University of British Columbia

Judith Bowen, MD, PhD, Elson S Floyd College of Medicine, Washington State University

Jonathan Ilgen , MD,MCR, Department of Emergency Medicine, University of Washington

Abstract: Educators frequently lament trainees’ struggles with clinical uncertainty, yet the paradox of how experienced clinicians take safe actions despite uncertainty remains poorly characterized. Recent studies have described how physicians experience and manage clinical uncertainty in the emergency department (ED). Yet these data highlight the centrality of context, specifically how clinicians use resources around them to tackle undifferentiated problems, suggesting that managing uncertainty in other settings might look quite different. Primary care visits represent the most common outpatient encounter in the U.S. and, in contrast to the ED, are characterized by established patient-doctor relationships, serial visits, and different available resources. Using a constructivist grounded theory approach, the proposed study seeks to explore how Internal Medicine primary care physicians (PCPs) experience and manage clinical uncertainty. Using a critical incident technique and rich pictures methodology, we will interview PCPs immediately following work in clinic. By analyzing qualitative data from these interviews, we will aim to inform future best practices by elaborating a conceptual framework that captures these clinicians’ experiences managing uncertainty in practice.

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