Practice inquiry: Uncertainty learning in primary care practice

Abstract

Most primary care physicians in nonacademic settings lack practice-based collegial forums for addressing the clinical uncertainty inherent in their work. Practice Inquiry (PI) comprises a set of small group methods designed for engaging case-based clinical uncertainty. Clinical uncertainty is defined as confusion and puzzlement around diagnostic, management, relationship, prognostic, and/or ethical issues coming from an individual patient case. PI targets learners at three levels: Practicing primary care clinicians, post-graduate trainees, and medical students. This chapter focuses on PI for practicing clinicians and reviews the need for workplace learning on set-aside time; describes PI group process using a scenario; reviews rationales underlying PI's focus on ‘the colleague group,’ case-based uncertainty, follow-up, and group facilitation; and sketches a hypothetical primary care setting – the inquiry practice - where clinicians work and learn from their patients using additional small group methods for studying patient panels and clinical phenomena of significance.