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Tolerance of ambiguity and psychological wellbeing in newly qualified doctors: An analysis over multiple time points.

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Title: Tolerance of ambiguity and psychological wellbeing in newly qualified doctors: An analysis over multiple time points.
Authors: Hancock, Jason1,2 jason.hancock@nhs.net, Ukoumunne, Obioha C.3, Burford, Bryan4, Vance, Gillian4, Gale, Thomas5, Mattick, Karen1
Source: Medical Education. Oct2025, Vol. 59 Issue 10, p1094-1104. 11p.
Subject Terms: *Occupational roles, *Psychological burnout, *Graduates, *Anxiety, *Research methodology, *Mental depression, Psychology of physicians, Sex distribution, Work environment, Questionnaires, Logistic regression analysis, Uncertainty, Psychological well-being, Age distribution, Descriptive statistics, Job stress, Physicians, Confidence intervals, Psychosocial factors, Regression analysis
Geographic Terms: United Kingdom
Abstract: Introduction: There is evidence of an association between tolerance of ambiguity and psychological wellbeing in doctors, but this relationship is not well understood. We explored this relationship, and the individual or workplace factors moderating it, in a population of newly qualified doctors. Methods: We examined the experiences of newly qualified doctors in the UK as they started a novel interim role (Time 1) and later moved into foundation year 1 roles (Times 2 and 3) during the COVID‐19 pandemic. Doctors completed the Tolerance of Ambiguity of Medical Students and Doctors scale (TAMSAD Range: 0–100), the Perceived Stress Scale (PSS: 0–40), the Hospital Anxiety and Depression Scale (HADS: 0–21) and the Copenhagen Burnout Inventory (CBI: 0–100), over four months. Cross‐sectional and longitudinal relationships between tolerance of ambiguity (TAMSAD) and wellbeing outcomes (PSS, HADS, CBI) were examined and potential moderators (age, gender, recent change in working environment) were explored. Results: A total of 451 participants completed the survey at Time 1, 214 at Time 2, 172 at Time 3. Higher tolerance of ambiguity was associated with lower levels of stress (regression coefficient: ‐0.09, R2 = 1.6%, p = 0.008), anxiety (−0.06, R2 = 1.6%, p = 0.009), depression (−0.03, R2 = 1.1%, p = 0.03) and workplace burnout (−0.40, R2 = 3.9%, p < 0.001) at Time 1. It was associated with lower levels of anxiety (−0.08, R2 = 2.4%, p = 0.03) at Time 2 and stress (−0.16, R2 = 3.4%, p = 0.02) at Time 3. Individual factors (being over 25 years, being female) and workplace factors (not moving location) seemed to strengthen the relationship between tolerance of ambiguity and psychological wellbeing. Conclusion: There appears to be a longitudinal relationship between lower tolerance of ambiguity and reduced psychological wellbeing in early career doctors within the UK. This study emphasises the importance of supporting all graduating doctors to navigate clinical ambiguity however further research is needed outside of the context of COVID‐19. Improved tolerance of ambigutiy is known to support improved wellbeing in newly qualified doctors. This study details the role training environment plays in that relationship. [ABSTRACT FROM AUTHOR]
Copyright of Medical Education is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Introduction: There is evidence of an association between tolerance of ambiguity and psychological wellbeing in doctors, but this relationship is not well understood. We explored this relationship, and the individual or workplace factors moderating it, in a population of newly qualified doctors. Methods: We examined the experiences of newly qualified doctors in the UK as they started a novel interim role (Time 1) and later moved into foundation year 1 roles (Times 2 and 3) during the COVID‐19 pandemic. Doctors completed the Tolerance of Ambiguity of Medical Students and Doctors scale (TAMSAD Range: 0–100), the Perceived Stress Scale (PSS: 0–40), the Hospital Anxiety and Depression Scale (HADS: 0–21) and the Copenhagen Burnout Inventory (CBI: 0–100), over four months. Cross‐sectional and longitudinal relationships between tolerance of ambiguity (TAMSAD) and wellbeing outcomes (PSS, HADS, CBI) were examined and potential moderators (age, gender, recent change in working environment) were explored. Results: A total of 451 participants completed the survey at Time 1, 214 at Time 2, 172 at Time 3. Higher tolerance of ambiguity was associated with lower levels of stress (regression coefficient: ‐0.09, R2 = 1.6%, p = 0.008), anxiety (−0.06, R2 = 1.6%, p = 0.009), depression (−0.03, R2 = 1.1%, p = 0.03) and workplace burnout (−0.40, R2 = 3.9%, p &lt; 0.001) at Time 1. It was associated with lower levels of anxiety (−0.08, R2 = 2.4%, p = 0.03) at Time 2 and stress (−0.16, R2 = 3.4%, p = 0.02) at Time 3. Individual factors (being over 25 years, being female) and workplace factors (not moving location) seemed to strengthen the relationship between tolerance of ambiguity and psychological wellbeing. Conclusion: There appears to be a longitudinal relationship between lower tolerance of ambiguity and reduced psychological wellbeing in early career doctors within the UK. This study emphasises the importance of supporting all graduating doctors to navigate clinical ambiguity however further research is needed outside of the context of COVID‐19. Improved tolerance of ambigutiy is known to support improved wellbeing in newly qualified doctors. This study details the role training environment plays in that relationship. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of Medical Education is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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        Value: 10.1111/medu.15743
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        Text: English
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      – SubjectFull: Psychological burnout
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      – SubjectFull: Graduates
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      – SubjectFull: Anxiety
        Type: general
      – SubjectFull: Research methodology
        Type: general
      – SubjectFull: Mental depression
        Type: general
      – SubjectFull: Psychology of physicians
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      – SubjectFull: Sex distribution
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      – SubjectFull: Work environment
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      – SubjectFull: Questionnaires
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      – SubjectFull: Logistic regression analysis
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      – SubjectFull: Psychological well-being
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      – SubjectFull: United Kingdom
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      – TitleFull: Tolerance of ambiguity and psychological wellbeing in newly qualified doctors: An analysis over multiple time points.
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              Text: Oct2025
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