Clinical Reasoning Uncertainty in Veterinary Medical Encounters with a Clinical Example

兽医诊疗中临床推理的不确定性——以临床实例为例

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Abstract

This narrative review examines the complexities of medical uncertainty in veterinary practice, highlighting its significant implications for clinical reasoning and decision-making. Veterinary professionals face inherent uncertainties due to factors such as biological variability, incomplete knowledge, and the pressures of rapidly evolving practices. The distinction between clinical ambiguity and medical uncertainty is crucial, as it informs the coping strategies employed by veterinarians. While uncertainty is often viewed negatively, it can stimulate curiosity and enhance problem-solving capabilities. This review categorizes uncertainty into aleatoric and epistemic types, offering insights into their origins and impacts on veterinary professionals and client interactions. The dynamic nature of uncertainty influences both immediate clinical encounters and long-term professional development, with varying effects based on individual tolerance levels and situational stakes. Despite the growing body of literature on uncertainty, veterinary education often neglects to address this critical aspect, leading to a gap in metacognitive competencies among practitioners. We have included a case example that offers explicit guidelines on the application of the Five Microskills model of clinical teaching. This model is proposed to assist veterinary professionals in effectively managing uncertainty. To enhance the quality of veterinary care, there is an urgent need to integrate uncertainty management into veterinary curricula and ongoing professional development. By fostering an environment that acknowledges and addresses uncertainty, veterinary professionals can improve their clinical reasoning, strengthen client relationships, and ultimately enhance patient outcomes. This review advocates for the adoption of evidence-based practices and collaborative approaches to navigate the complexities of uncertainty, ensuring high standards of care in veterinary medicine.

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