PCW-24 · Preview · IBM Carbon
P PCW-24 · Pre-Conference Workshop
Block 1 · Framing Ambiguity
A provocation to begin

Medicine declares it builds clinicians for uncertainty. The data says otherwise.


Over a single year of clinical clerkship, tolerance of ambiguity drops by 26 percent. Perfectionism stays intact. The erosion is not accidental. It is architectural.

Workshop
Navigating Ambiguity and Complexity
Building Future Literacy in Health Professions Education
Co-facilitators
Knopfholz · Tempski · Arruda Martins · Han · Karam
PUCPR · USP · SIU School of Medicine
AMEE 2026 Vienna · Sun 23 Aug · 13:30–16:30 · Austria Center Knopfholz · Tempski · Arruda Martins · Han · Karam
P Block 1 · Framing Ambiguity
Slide 04 · Empirical evidence
TAMSAD decline over one year of clerkship
−26.2%

Tolerance of ambiguity score fell from 59.57 to 43.90 in 105 medical students. Perfectionism scores remained stable. The inverse coupling intensified.

t = 10.41 p < 0.001 n = 105

Ndoja, Chahine, Sibbald · BMC Medical Education · 2020 · 20:138

TAMSAD score · Canadian cohort Source: Ndoja 2020
70 60 50 40 59.57 43.90 Start of clerkship End of clerkship
Block 1 · Framing Ambiguity PCW-24 · AMEE 2026 Vienna
Working hypothesis · PCW-24
We are not building future literacy.
We are eroding it during the very moment we say we are building it.

Hold the question

P Block 3 · Design Sprint
Learning from the Future · 35 min in groups
Future Literacy Canvas

Prototype an educational intervention that builds Future Literacy as a declared competency.

v1.0 · 2026
01 · Learner profile

Which student, in which year of training, with which prior mindset baseline?

02 · Future signal

Which not-yet-here scenario will operate as raw pedagogical material (AI, climate, virtual ward)?

03 · Anticipation skill

Which specific future-literacy capacity is the learner expected to acquire, in operational terms?

04 · Pedagogical method

Uncertainty journal, foresight debate, ambiguous case sim, productive failure exercise.

05 · Evidence of impact

Which validated instrument or programmatic-assessment artifact will detect change?

06 · Monday-morning action

The single concrete move you will execute in your home institution within the next 30 days.

Karam & Knopfholz · adapted from Business Model Canvas (Osterwalder, 2010) for educational design Block 3 · Slide 09
P PCW-24 · Closing
Block 5 · Commitment to Action
pcw24@jarviszenkaram.com
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Slides, full dossier with the nine source papers, blank Future Literacy Canvas, 30-day reflection prompts, and a follow-up six weeks from today asking what you implemented.

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