First year junior doctors and medical uncertainty - a qualitative study. / LIS1-leger og medisinsk usikkerhet ­ en kvalitativ studie.

BACKGROUND: Few studies have investigated how doctors in Norway deal with medical uncertainty. The purpose of the study was to explore how first year junior doctors perceive and manage uncertainty in clinical practice. MATERIAL AND METHODS: Ten first year junior doctors at two hospitals in Norway were recruited for interviews following response pattern analysis from a mapping questionnaire. The interviews were analysed using systematic text condensation. RESULTS: The analysis revealed three main themes in the interviews: dealing with medical uncertainty, personal response to medical uncertainty, and working environment, feedback and preparation. Within all three thematic areas, the informants used the words 'certain/uncertain' and 'secure/insecure' interchangeably. INTEPRETATION: The first year junior doctors struggled with the inherent uncertainty of medicine and felt a marked sense of insecurity, particularly at the start of their training period. How the doctors were welcomed in the workplace and the feedback they were given were important factors. Their undergraduate medical education had not sufficiently prepared the first year junior doctors for how to deal with medical uncertainty in clinical practice.

Understanding how different mechanism of life coaching offered to young adults with type 1 diabetes can improve their ability to see opportunities and overcome barriers.

OBJECTIVE: The purpose of this study was to gain a greater understanding of the potential mechanisms of life coaching in relation to young people with Type 1 diabetes (T1DM); including how it influences their motivation and their ability to see opportunities and overcome barriers. METHODS: Within the theoretical framework of realistic evaluation theory this qualitative study was conducted at three different hospitals where a total of 10 young adults with T1DM were coached as a supplement to their usual care at the hospital. Data were collected through semi-structured interviews and a focus group interview. RESULTS: The findings showed that the young adults obtained a better self-awareness, and analyse of the coaching sessions point at several separate coaching mechanisms that seem to improve the young adults' sense of well-being and personal empowerment in relation to their diabetes. CONCLUSION: Life coaching could be an important supplement to more traditional diabetes follow-up in the specialized health care system. PRACTICE IMPLICATIONS: The results of this study imply that the capacity to deliver life coaching to young adults with T1DM can have broad implications for supporting them in obtaining better regulated diabetes and living a better daily life.