Background: There is a growing interest in the influence of variables that may negatively influence the reasoning of health care professionals, namely intolerance of uncertainty, defined as health care professionals' difficulty tolerating ambiguous situations that often trigger discomfort, overtesting, and suboptimal treatment choices, and resource consumption, defined as the ordering of unnecessary diagnostic tests that can waste resources and compromise decision-making.
Objective: Our purpose was to assess the influence of intolerance of uncertainty and resource consumption on the chosen therapeutic strategy.
Methods: A total of 127 physiotherapists were challenged to play a simulation game and choose a therapeutic strategy for 3 cases of low back pain of increasing difficulty (easy, medium, and difficult). Their intolerance of uncertainty level and their resource consumption were measured (ie, requests for test results for each case).
Results: Results showed that 87.4% (111/127) of participants chose the most appropriate strategy (ie, the one in line with the strategy recommended by experts) for the easy case, 46.5% (59/127) for the medium, and 29.1% (37/127) for the difficult. For the easy case, intolerance of uncertainty and resource consumption had a negative influence on the chosen therapeutic strategy, which was less appropriate (β=-4.03, t121=-3.92, P<.001). Moreover, resource consumption among highly intolerant individuals had a more adverse influence on the chosen strategy (β=-3.42, t121=-5.09, P<.001). Such results were not found for the medium and difficult cases.
Conclusions: Resource consumption may have a negative influence in some cases on the treatment strategies chosen by the physiotherapists who are most intolerant of uncertainty. Future research avenues are suggested to ensure the quality of patient care concerning physiotherapists' level of intolerance of uncertainty.
Keywords: clinical reasoning; intolerance of uncertainty; physiotherapists; simulation game; therapeutic strategy.
©Clémence Brun, Alexis Akinyemi, Laurène Houtin, Philippe Meidinger, Jimmy Antunes, Richard Monvoisin, Nicolas Pinsault, Oulmann Zerhouni. Originally published in JMIR Rehabilitation and Assistive Technology (https://rehab.jmir.org), 18.11.2025.