How does narrative medicine impact medical trainees’ learning of professionalism? A qualitative study

Abstract

Background Narrative medicine (NM) is an approach involving narrative skills and is regarded as a model for medical humanism and effective medical practice. This study aims to explore how NM impacts medical trainees’ learning of professionalism during a clerkship in a Taiwanese clinical setting. Methods A qualitative interview study adopting a purposive sampling method was undertaken. Thirty medical trainees participated in this study, including five fifth-year medical students (MSs), ten sixth-year MSs, nine seventh-year MSs, and six postgraduate year (PGY) trainees. Thematic framework analysis was applied, and a modified realist evaluation approach was further used to analyse the interview data. Results We identified self-exploration, reflection, and awareness of professional identity as mechanisms explaining how NM impacted professionalism learning in our participants. Furthermore, empathy, communication, doctor-patient relationship and understanding patients were identified as the outcomes of the NM intervention for trainees’ learning of professionalism. Conclusions NM facilitates medical trainees’ self-exploration, reflection, and awareness of professional identity, thereby affecting their learning of professionalism in clinical settings. Adopting NM as an educational intervention in undergraduate medical education could play an important role in professionalism learning, as trainees can thereby be supported to gradually develop self-exploration and reflection capabilities and heightened awareness of professional identity reflectively through a narrative process.

Narrative medicine as a teaching strategy for nursing students to developing professionalism, empathy and humanistic caring ability: a randomized controlled trial

“…Therefore, the results of this study confirm that narrative medical theory education and narrative writing play a good role in the training of professionalism in nursing students. Previous qualitative research has suggested that narrative medicine has been found to positively influence the development of professional identity and professional literacy [ 42 , 43 ]. Narrative-based medical education promote medical interns’ perceptions of self-exploration, reflection, and awareness of professional identity, thereby influencing their learning of professionalism in clinical settings [ 42 ].…”

“…Previous qualitative research has suggested that narrative medicine has been found to positively influence the development of professional identity and professional literacy [ 42 , 43 ]. Narrative-based medical education promote medical interns’ perceptions of self-exploration, reflection, and awareness of professional identity, thereby influencing their learning of professionalism in clinical settings [ 42 ]. During the narrative writing process, participants in the intervention group observe or describe their interactions with patients and the behaviors of clinical healthcare professionals from a reflective perspective, thus sharing the new knowledge and skills they have learned, as well as their perceptions and outlook on values, sense of mission, and professional identity [ 42 , 44 ].…”

“…Narrative-based medical education promote medical interns’ perceptions of self-exploration, reflection, and awareness of professional identity, thereby influencing their learning of professionalism in clinical settings [ 42 ]. During the narrative writing process, participants in the intervention group observe or describe their interactions with patients and the behaviors of clinical healthcare professionals from a reflective perspective, thus sharing the new knowledge and skills they have learned, as well as their perceptions and outlook on values, sense of mission, and professional identity [ 42 , 44 ]. Participants in the control group, on the other hand, would not, and they often stood to describe changes in their own professional skills more from their own perspective.…”

Knowledge, Attitude, and Practice regarding Narrative Medicine among Chinese Medical Personnel: An Online Cross-Sectional Survey

“…Since there has been limited literature on the long-term effect of NM on medical students and facilitators, large-scale promotion may start with pilot programs in several specific departments (e.g., oncology department and geriatrics department) in certain areas; and various new approaches could be tested. Studies have shown that on-site field practice and regular “sharing meetings” guided by NM professionals are generally more effective than traditional lectures [ 30 ]. Strategies may also be customized to suit the medical personnel's habits and the workflows of their specialty [ 31 ].…”

Role of narrative medical education in cultivating empathy of general practitioners

“…Furthermore, narrative medicine is often patient-centered and emphasizes humane patient conditions, which not only requires relieving and even eliminating the patients' symptoms and pain but also pursues harmony and health [14] . Thus, narrative medical education can improve the individual general practitioners' medical and humanistic literacy and enhance doctor-patient harmony [15] . These ndings indicated that narrative medicine plays a vital role in the standardized training system of resident physicians.…”