Publication Date

2025

Document Type

Dissertation/Thesis

First Advisor

Henry, Beverly W.

Degree Name

Ph.D. (Doctor of Philosophy)

Legacy Department

School of Health Studies

Abstract

Uncertainty is characterized as unpredictability or doubt about a situation or outcome. Pervasive throughout medical practice, uncertainty and providers’ responses to uncertainty have widespread impacts on healthcare. Increased healthcare costs, patient safety concerns, and impaired clinical decision-making are all negative outcomes which can result when providers are intolerant of uncertainty. Furthermore, the inability to deal with uncertainty has been found to relate to reduced mental health and self-compassion, higher need for cognitive closure, and poor decision-making in medical and chiropractic students. While uncertainty tolerance (UT) and its impacts have been studied in medicine and other healthcare fields such as nursing, there is little understanding about UT in Doctor of Physical Therapy (DPT) students. The purpose of this descriptive correlational study was to quantitatively and qualitatively investigate UT in DPT students across levels of learners. A total of 152 students participated in the study, with uneven distribution among levels of learners. A convergent mixed methods design was used to gain a comprehensive understanding of UT in DPT students through the Intolerance of Uncertainty Scale short-form (IUS-12) and open-ended survey questions. Relationships between DPT students’ UT and need for closure, self-efficacy for clinical reasoning, and clinical decision-making were explored through the Need for Closure scale short version (NFCS), the Physical Therapy Self-Efficacy scale (PTSE), and the Clinical Decision Making (CDM) tool. Within-case analysis of each level of learner and cross-case analysis comparing learner levels was performed using thematic analysis of two open-ended survey responses. Integration of data was performed through joint display analyzing how quantitative findings were reflected in the qualitative results. Quantitative findings revealed no group differences in UT as measured by the IUS-12 across levels of learners. Moderate positive associations between IUS-12 scores and NFCS scores were found for the total sample as well as level one and level two learners. Moderate negative associations between IUS-12 scores and CDM scores for level three learners were found. Qualitative results demonstrated differences in cognitive, emotional, and behavioral responses to uncertainty across levels of learners. Level one and level two learners reported perceiving variable amounts of change in UT compared to level three learners as well as more negative responses to uncertainty than level three learners. Mixed methods integration found that quantitative results were not clearly reflected in the qualitative findings, suggesting that UT is complex and that the IUS-12 alone may not provide a comprehensive understanding of UT and responses to uncertainty in DPT students. Additionally, the perceived negative responses to uncertainty reported in level one and level two learners which were absent in level three learners, have practical implications for UT development and assessment. This project sheds light on a largely unstudied concept in physical therapist education and paves the way for investigation into potential interventions and education for future healthcare providers who may struggle with uncertainty.

Extent

197 pages

Language

en

Publisher

Northern Illinois University

Rights Statement

In Copyright

Rights Statement 2

NIU theses are protected by copyright. They may be viewed from Huskie Commons for any purpose, but reproduction or distribution in any format is prohibited without the written permission of the authors.

Media Type

Text

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