Dr. Nathalia Costa - The Ubiquity Of Uncertainty: Learnings From The Low Back Pain Context

About: Uncertainty is inherent to, and ubiquitous in, clinical practice. Yet practical guidance on how to navigate uncertainty remains largely underexplored in both training and research alike. This session draws from findings from the low back pain literature specifically, and the healthcare literature more broadly, to stimulate the audience to both critically reflect about how we (clinicians, patients and researchers) navigate uncertainty and explore possibilities.
The session starts with a 45-minute presentation which provides an overview of the uncertainty literature and invites the audience to both dive into real-world stories and engage in reflexivity. The presenter will then introduce a productive way of navigating uncertainty without always focusing on reducing it, using Barbara Gibson’s ‘ethic of openness’. The session will end with a 15-minute Q&A, where participants will have an opportunity to both share their experiences with uncertainty and ask questions.
By the end of the presentation, participants will have a better understanding of how to navigate uncertainty and will leave the presentation feeling better equipped to navigate uncertainty within pain management settings.
Citations:
Costa N, Olson R, Mescouto K, Hodges PW, Dillon M, Evans K, Walsh K, Jensen N, Setchell J. Uncertainty in low back pain care - insights from an ethnographic study. Disabil Rehabil. 2022 Feb 21:1-12.
Wieringa S, Engebretsen E, Heggen K, Greenhalgh T. Clinical guidelines and the pursuit of reducing epistemic uncertainty. An ethnographic study of guideline development panels in three countries. Soc Sci Med. 2021 Mar;272:113702.
Mescouto K, Olson RE, Hodges PW, Setchell J. A critical review of the biopsychosocial model of low back pain care: time for a new approach? Disabil Rehabil. 2020 Dec 7:1-15.
Simpkin AL, Armstrong KA. Communicating Uncertainty: a Narrative Review and Framework for Future Research. J Gen Intern Med. 2019 Nov;34(11):2586-2591. doi: 10.1007/s11606-019-04860-8. Epub 2019 Jun 13.
Gibson BE. Post-critical physiotherapy ethics: a commitment to openness. In: BE Gibson, D Nicholls, J Setchell, KS Groven, editors. Manipulating practice; a critical physiotherapy reader. Oslo (Norway): Cappelen Damm Academic Publishing. 2018; p. 35-54.
Nathalia Costa, BPhy (Hons), Ph.D. is a Postdoctoral Research Fellow at the School of Health and Rehabilitation Sciences, University of Queensland, and at Sydney School of Public Health, The University of Sydney, Australia. She has expertise in musculoskeletal health, with a focus on low back pain.
In her postdoctoral studies at The University of Queensland, Nathalia is investigating how clinicians and people who experience low back pain navigate uncertainty during clinical encounters, with a view to inform training needs of clinicians for navigating uncertainty within this context.
In her postdoctoral studies at the University of Sydney, Nathalia is identifying both policy and health system reform opportunities to improve low back pain management. Her research spans from factors that impact on pain trajectories to individual, organizational and system factors that create barriers to, and facilitators for, care that is person-centred and equitable.