Teaching the Communication of Diagnostic Uncertainty at Scale: Leveraging a Mobile App for Just-in-Time Instruction

Abstract

Diagnostic uncertainty is a reality of clinical care, particularly in emergency medicine. The ability to communicate this uncertainty to patients and families, however, remains underdeveloped in medical education curricula. Traditional simulation training is regarded as the gold standard for teaching difficult conversations, but resource constraints can limit access, especially for larger cohorts of learners. Faced with this challenge, we turned to a tool our team developed: the Uncertainty Communication mobile application (app). With over 200 medical students entering their fourth year of training, we used this app to deliver real-time, large-scale, skill-based learning, without simulation rooms, standardized patients, or small-group role-play. Students practiced communicating diagnostic uncertainty to patients, received immediate feedback, and reflected on patient-centered communication strategies. Their responses were generally positive. While not a formal study or intended to replace the role of traditional simulation training, our experience reaffirms how the intentional integration of mobile tools into medical training can introduce complex skills, like communicating diagnostic uncertainty, into scalable and practical learning solutions. As we train the next generation of physicians, such tools may offer educators some degree of flexibility when training large cohorts of students.

Keywords: communication training; diagnostic uncertainty; emergency medicine; medical simulation; undergraduate medical education.

Figure 1. Example of fictional patient scenario in the Uncertainty Communication app