Navigating clinical uncertainty in primary care: communication, safety-netting and reflective practice
Tali SAHAR
Uncertainty is inherent to primary care, arising from undifferentiated symptoms, multimorbidity, time pressure and limited investigations. When unaddressed, it can lead to over-testing, defensive practice, clinician burnout and patient anxiety. Yet explicit training in how to recognise, tolerate and communicate clinical uncertainty is still limited in many family medicine settings. This interactive workshop aims to provide practical tools for navigating diagnostic and prognostic uncertainty in everyday consultations.Identify common sources and patterns of clinical uncertainty in primary care consultations. Use concrete communication strategies that acknowledge uncertainty while maintaining trust and partnership. Apply structured safety-netting and shared decision-making in situations of residual uncertainty (e.g. persistent pain, non-specific symptoms, multimorbidity). Reflect on their own emotional responses to uncertainty and how these responses influence clinical decisions.This 60-minute workshop combines brief evidence-informed presentations with highly interactive learning. Using real-world primary care vignettes, participants will work in small groups to map types of uncertainty (diagnostic, prognostic, therapeutic) and their usual responses. Role-plays and/or fishbowl demonstrations will be used to practise specific phrases for naming uncertainty, negotiating follow-up and safety-netting, and exploring patient preferences. Facilitated reflection will invite participants to notice emotional and cognitive reactions to uncertainty and discuss strategies for coping (peer support, supervision, mindful pause, deliberate “watchful waiting”). Workshop schedule 10 min – Introduction: why uncertainty matters in primary care 15 min – Small-group case work: mapping uncertainty and usual responses 20 min – Skills practice: communication phrases, safety-netting and shared decisions 10 min – Plenary synthesis: key strategies and take-home tools 5 min – Evaluation and individual action plansParticipants will leave with a shared language for discussing uncertainty, a set of tested communication phrases, and a simple framework for safety-netting in common primary care scenarios..Our aims is to supporti Family physicians' confident, transparent and patient-centred care in the face of unavoidable uncertainty
