Transitioning from the world of ABCD’s to the world of uncertainties

From Kindergarten up until university, we are trained to believe that there is only one correct answer, and if we choose the correct answer, then we will be rewarded. This reward works as a positive reinforcement, and so we always strive to pick the correct option whenever we are given multiple choices to choose from. For example, due to large class size, most undergraduate classes use multiple choice format in tests and exams. This means that to get a question correct, students are required to choose the most correct option out of A, B, C, D, and E choices. There are no uncertainties there, you either know the answer and get a point or do not know answer and loose the opportunity to earn a point.

The real world is quite different than the academic world. In the real world, we are faced with all kinds of uncertainties. There are many options to choose from, but there is no one “correct answer”. For example, what if you land up with multiple job offers and don’t know which one will be the correct choice? How many universities should you apply to so that you have a reasonable chance of obtaining admission to the program of your choice? When recent university or college graduates first step into the real world, they face a lot of confusion about making right choices. This is because the first 20 years or so of their life, they are trained to think in a way that is different from the characteristics of the real world.

One effective method of teaching would be to test students in a way that requires them to explore options and effectively defend the option they choose. In other words, there are no right or wrong answers. Everything depends on individual characteristics including personal life experiences, critical thinking skills, and knowledge.

Uncertainties also exist in the world of medicine. Maybe the mammogram result of a patient is false positive, what should the doctor tell the patient? If a patient is suffering from heart failure, how should the doctor answer his/her question about whether they will survive until their granddaughter’s wedding? Despite the prevalence of uncertainties, physicians and clinicians are able to provide adequate answers and support to the patients and their families. These compassionate individuals use good judgements based on their earlier experiences and knowledge. They do the best they can from the available evidence. However, sometimes, simply saying “Sorry, I do not know” would help the patients more than saying something without enough supporting evidence.

Is acknowledging uncertainties, a good practice in medicine? It can help patients make informed decisions. For example, they might choose to seek second opinion from someone else. In this way, patient-physician relationships are built on trust, and they work together as a team to come up with a solution that is most favourable for each patient.

However, patients tend to think that having definitive answers to all questions is a characteristic of a good doctor. Is it really? The real problem is that the field of medicine itself is limited to how much it can offer. In that sense, honesty among doctors would be more admirable than their ability to come up with a definitive diagnosis.

Transitioning from a world of multiple choices with one correct answer to a world of “what if’s” can be challenging, at first. In the real world, the more you look, the more options you will find, which can lead to confusion. However, acknowledging the uncertainty and looking at the pros and cons of each option may help to reach a favorable decision.




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