PCW-24 · Preview · Stripe
PCW-24 · Navigating Ambiguity and Complexity
Block 1 · Framing Ambiguity · 00:00
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.

Building Future Literacy · in Health Professions Education
AMEE 2026 Vienna · Sun 23 Aug · 13:30–16:30
Knopfholz · Tempski · Arruda Martins · Han · Karam
PCW-24 · Block 1
Slide 04 · Empirical evidence
TAMSAD decline over one year of clerkship
−26.2%

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

t = 10.41 p < 0.001 n = 105

Ndoja et al., BMC Medical Education, 2020

TAMSAD score · Canadian cohort
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
PCW-24 · Block 3 · Design Sprint
35 min in groups · A3 canvas at each table
Learning from the Future

Future Literacy Canvas

Prototype one educational intervention that builds Future Literacy as a declared competency in your medical curriculum.

v1 · for piloting with co-facilitators
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.

Co-built by Karam & Knopfholz · adapted from Business Model Canvas (Osterwalder, 2010) for educational design
Block 3 · Slide 09
PCW-24 · Closing
Block 5 · Commitment to Action
Opens email pre-filled · pcw24@jarviszenkaram.com
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