Exploring the presence and roles of humility when experiencing situations of uncertainty

Background

Uncertainty is a pervasive challenge in clinical practice. Whereas the importance of humility in navigating uncertainty has been discussed, empirical research on how humility is practiced or expressed (i.e., humility in action) is lacking. This study examines humility's presence and role in physicians' uncertainty experiences during the COVID-19 pandemic. The objectives were to determine if and how humility presented 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

After intercoder reliability was established, four members of the author team utilized qualitative data analysis software to conduct a secondary analysis of critical incident interviews with 12 physicians (seven ED and five ICU physicians) about experiences with uncertainty while caring for COVID-19 patients. To identify if humility was present in situations of uncertainty, the authors deductively coded transcripts for key elements of humility based on previously published conceptualizations by Tangney (2000) and Gruppen (2015). Additionally, the authors examined code co-occurrence to identify clusters of humility and conducted a thematic analysis to uncover potential roles of humility and what humility “looks like” in clinical situations.

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.

Conclusions

Findings suggest that humility facilitates managing uncertainty by promoting trust in abilities and enabling flexibility and openness. Formal training in humility may better prepare clinicians for uncertainty. Further research should explore nuances of humility across clinical situations and types of uncertainty.