Humility in Times of Heightened Uncertainty: A Study of Physician Critical Incidents to Prepare Learners for Uncertainty in Clinical Practice

Background: Uncertainty is a pervasive challenge in clinical practice.While the importance of humility in addressing uncertainty has been discussed in the literature, empirical research on this topic is lacking.Our study aimed to examine the presence and role of humility in physicians' experiences with uncertainty during the COVID-19 pandemic.Objectives: To identify if and how humility was present in physicians' reflections on uncertain situations during the height of the COVID-19 pandemic, and to explore potential roles of humility in managing uncertainty.Methods: We conducted critical incident interviews with 12 EM and ICU physicians about their experiences with uncertainty while caring for COVID-19 patients.We deductively coded transcripts for key elements of humility based on conceptualizations by Tangney (2000) and Gruppen (2015).We examined code co-occurrence to identify clusters of humility and conducted iterative thematic analysis to uncover potential roles of humility.Results: Aspects of humility were frequently present in physicians' narratives.Acknowledgment of shortcomings was most common.Acceptance of limitations, openness, and perspective-taking frequently co-occurred.Two key themes emerged: humility allowed physicians to trust their training despite uncertainty, and enabled pivoting and adapting to new information.Conclusion: Findings suggest humility facilitates managing uncertainty by promoting trust in abilities and enabling flexibility and openness.There are opportunities in undergraduate medical education to include formal training and specific skills development in humility to prepare learners to navigate clinical uncertainty.Further research should explore nuances of humility across clinical situations and types of uncertainty.