Physicians' Reactions to Uncertainty: Refining the constructs and scales

The Physicians' Reactions to Uncertainty (PRU) scales were developed to measure physicians' affective reactions to uncertainty. However, the structural (factor) model for the two PRU scales has not been cross validated on an independent sample of physicians. We surveyed 337 physicians in internal medicine at Indiana University to test the structural model for the PRU scales using confirmatory factor analysis and, if necessary, to refine the constructs and scales. The structural model of the original PRU scales did not fit the data (X²=559.26,p<.001) provided by the 265 (79%) respondents. Based on models suggested by 15 volunteers, we refined the constructs and scales. The four new scales are Anxiety Due to Uncertainty (five items,=.85), Concern about Bad Outcomes (three items,=.74), Reluctance to Disclose Uncertainty to Patients (five items,=.76), and Reluctance to Disclose Mistakes to Physicians (two items,=.75). The revised structural models have greater conceptual clarity, better fit to the data, and shorter scale measures than the original PRU model.This research was supported in part by National Research Service Award HS00032 from the Agency for Health Care Policy and Research.