Impact of a narrative medicine programme on healthcare providers’ empathy scores over time

Chen, Po-Jui; Huang, Chiung‐Yi; Yeh, San‐Jou

doi:10.1186/s12909-017-0952-x

Cited by 62 publications

(75 citation statements)

References 38 publications

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“…The integration of narrative and medicine offers benefits to healthcare providers as well as to patients, since NM draws on literature’s unique ability to augment clinical competencies, enhance the moral imagination and foster interpersonal understanding 9 13. Narrative-based education shows promise for promoting communication,14 cultural competence,15 empathy16–18 and professionalism,19 as well as for enhancing vitality and mitigating burnout 20–22. To reap the benefits associated with NM, many academic medical institutions have implemented humanities-based educational initiatives into the curricula 23.…”

Section: Introductionmentioning

confidence: 99%

Content and outcomes of narrative medicine programmes: a systematic review of the literature through 2019

et al. 2020

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ObjectivesNarrative medicine (NM) incorporates stories into health sciences paradigms as fundamental aspects of the human experience. The aim of this systematic review is to answer the research question: how effective is the implementation and evaluation of NM programmes in academic medicine and health sciences? We documented objectives, content and evaluation outcomes of NM programming to provide recommendations for future narrative-based education.MethodsWe conducted a systematic review of literature published through 2019 using five major databases: PubMed, Embase, PsycINFO, ERIC and MedEdPORTAL. Eligible NM programming included textual analysis/close reading of published literature and creative/reflective writing. Qualifying participants comprised individuals from academic medicine and health sciences disciplines. We reviewed and categorised programme goals, content and evaluation activities to assess participant satisfaction and programme efficacy. Two members of the research team assessed the risk of bias, independently screening records via a two-round, iterative process to reach consensus on eligibility.ResultsOf 1569 original citations identified, we selected 55 unique programmes (described in 61 records). In all, 41 (75%) programmes reported a form of evaluation; evaluation methods lacked consistency. Twenty-two programmes used quantitative evaluation (13 well described), and 33 programmes used qualitative evaluation (27 well described). Well-described quantitative evaluations relied on 32 different measures (7 validated) and showed evidence of high participant satisfaction and pre-post improvement in competencies such as relationship-building, empathy, confidence/personal accomplishment, pedagogical skills and clinical skills. An average of 88.3% of participants agreed or strongly agreed that the programme had positive outcomes. Qualitative evaluation identified high participant satisfaction and improvement in competencies such as relationship-building, empathy, perspective-taking/reflection, resilience and burnout detection/mitigation, confidence/personal accomplishment, narrative competence, and ethical inquiry.ConclusionEvaluation suggests that NM programming leads to high participant satisfaction and positive outcomes across various competencies. We suggest best practices and innovative future directions for programme implementation and evaluation.

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Section: Introductionmentioning

confidence: 99%

Content and outcomes of narrative medicine programmes: a systematic review of the literature through 2019

et al. 2020

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“…This may include strengthening the skills for teaching the affective domain as a focus of health science programs [46]. However, the difficulty with imparting and assessing in-program values and attitudes in an effective way needs further attention, because design intentions around affect are not guaranteed to be realised [12]. There are risks associated with telling students about attitudes they should have in an explicit teaching mode, where the latter fosters a compliance mentality that does not guarantee transfer to work.…”

Section: Discussionmentioning

confidence: 99%

“…While attitudes and values for EBP have been determined to be under-developed in a variety of articles, there are problems inherent with these quantitative studies. Many studies in health sciences have used self-report surveys to determine affective elements [10,11] such as empathy [12,13] and emotional intelligence [10] despite concerns with the reliability and validity of questionnaires that pertain to the affective domain [11]. For example, a longitudinal cohort study showed that empathy dropped in the 3rd year of a medical degree, and never recovered its earlier levels subsequently [12].…”

Section: Introductionmentioning

confidence: 99%

Graduates’ affective transfer of research skills and evidence based practice from university to employment in clinics

et al. 2020

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Background: This research sought to determine the impact of explicit program-based development of skills associated with research and Evidence Based Practice (EBP) on the attitudes and sustained behaviours of graduates subsequently employed in clinics. Systematic reviews have shown that university teaching of EBP and research skills rarely result in transfer of commensurate attitudes and sustained behaviours of students to their subsequent studies or to employment. Studies have therefore called for detailed exploration of what may enable this transfer of knowledge and skills to attitudes and behaviours. In keeping with these calls, this paper presents a fine-grained qualitative study of graduates' research skills and EBP in clinics with particular reference to pertinent attitudes, values and behaviours sustained, or further developed, one year after program completion. Methods: The study revolved around employed graduates of a Bachelor of Oral Health (BOH) program, which used the Research Skill Development (RSD) framework to structure the explicit, coherent and cyclic development of the skills associated with research in multiple semesters of the degree. One year after their completion of the BOH program, semi-structured interviews were conducted with nine employed graduates, three from each of three consecutive cohorts, to gain their professional perspectives on their research skills and EBP developed at university and then used in clinics. While the predetermined interview questions focused on employed graduates' knowledge and skills, the attitudes and values around research skills and EBP emerged spontaneously. Results: Graduates that were interviewed relayed in detail their attitudes and values associated with research skills and EBP when asked about their work in clinics, even though the affective elements were not specifically elicited. In the employment context, the positive affective aspects of the skills associated with research and EBP that graduates discussed were pronounced, and this contrasted with working graduates retrospective view of university research skills and EBP. Conclusions: The richness of affective interaction with patients was a factor that enabled the interviewed graduates to transfer university knowledge and skills into attitudes and behaviours associated with EBP. We recommend similar fine-grained qualitative research to further develop constructs that enable quantification of the interplay of cognitive and affective facets in researching and EBP.

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“…49 At present, in medical education and clinical practice, the role of narrative medicine in enhancing the empathetic ability of medical staff and helping promote patients' outcome has been well-established. 50,51 Doctors should pay attention to practicing the concept of narrative medicine, and encourage patients to tell stories about their diseases, demonstrate empathy to patients in stories, and integrate narrative medicine into patient education. Narrative medicine education and empathy training should be included in medical education, especially in developing countries where medical humanities education is lacking, as to improve the physical and mental health of patients.…”

Section: Narrative Medicine: the Way To Realize Doctor-patient Empathymentioning

confidence: 99%

<p>Care Is the Doctor’s Best Prescription: The Impact of Doctor-Patient Empathy on the Physical and Mental Health of Asthmatic Patients in China</p>

Wu¹,

Zhang²,

et al. 2020

PRBM

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These authors contributed equally to this workBackground: To explore the impact of empathy between Chinese doctors and patients on anxiety, self-efficacy, sleep and IL-6 levels in hospitalized asthmatic patients. Methods: This study included 195 asthmatic patients and 30 respirologists in China. The Jefferson Empathy Scale (JSE) was used to measure the empathy level of doctors, and the consultation and relational empathy (CARE) scale was used to measure patients' perception of empathy between themselves and their doctors. Doctors were divided into three groups, according to JSE scores. Data about anxiety, self-efficacy, sleep and IL-6 were collected and compared between patients in different JSE groups at admission (T1) and 3 months later (T2). The correlation between JSE scores and CARE scores was analyzed. Pearson correlation analysis along with a structural equation model was applied to explore the relevance among anxiety, self-efficacy, sleep, inflammatory factors (IL-6) and patients' perception of empathy shown by their doctors. Results: There was no statistical difference between the indices of patients in three groups at admission. For all patients, the changes of indicators were statistically different from T1 to T2. Three months later, patients in high empathy scoring group showed lower anxiety and IL-6, and higher self-efficacy and sleep quality. There was a positive correlation between JSE and CARE scores. Patients' perception of doctor-patient empathy was negatively correlated to anxiety levels and IL-6, and positively correlated to self-efficacy and sleep quality. Anxiety, self-efficacy and sleep quality were mediators in the relationship between patients' perception of empathy and IL-6. Conclusion: In the Chinese sample, anxiety, self-efficacy, sleep, empathy between doctors and patients and IL-6 are closely correlated. Anxiety, self-efficacy and sleep may play additional roles in the influence of patients' perception of empathy between doctors and patients on IL-6 in asthmatic patients.

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Impact of a narrative medicine programme on healthcare providers’ empathy scores over time

Cited by 62 publications

References 38 publications

Content and outcomes of narrative medicine programmes: a systematic review of the literature through 2019

Content and outcomes of narrative medicine programmes: a systematic review of the literature through 2019

Graduates’ affective transfer of research skills and evidence based practice from university to employment in clinics

<p>Care Is the Doctor’s Best Prescription: The Impact of Doctor-Patient Empathy on the Physical and Mental Health of Asthmatic Patients in China</p>

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