A revised model of uncertainty in complex healthcare settings: a scoping review

Background: Uncertainty is a ubiquitous and dynamic presence throughout healthcare systems and encounters, affecting the quality and safety of care. Although previous research has attempted to categorize varieties of uncertainty, it is not clear if these classifications are applicable across various healthcare settings. Objective: The purpose of this review was to examine the applicability of the issues of uncertainty delineated in an established taxonomy across diverse healthcare domains, professions, and countries and to consider the complexity of these issues. Methods: Drawing on empirical research from three databases, we conducted a scoping review of the literature to identify types of uncertainty experienced by healthcare professionals. A framework synthesis design was employed to review and synthesize the literature across multiple healthcare settings. Results: The search identified 2285 articles, of which 94 met the inclusion criteria. Findings from included studies suggested professional uncertainty in healthcare is complex and pervasive. On the basis of our inability to categorize some studies in the issues of uncertainty outlined in the existing taxonomy, we proposed a revised model of uncertainty for healthcare professionals. Conclusions: The revised model of uncertainty, the model of uncertainty in complex healthcare settings (MUCH-S), is applicable to various healthcare ecosystems and proposes a reflexive archetype that recognizes different issues of uncertainty while establishing that these are often interrelated in healthcare systems. This review offers healthcare professionals greater levels of understanding of this complex phenomenon and may support more informed and reflective decision-making, assisting them to better navigate uncertainties experienced in healthcare workplaces.