Implementing an interprofessional narrative medicine program in academic clinics: Feasibility and program evaluation

Abstract

Interprofessional education (IPE) is a critical component of medical education and is affected by the characteristics of the clinical teams in which students and residents train. However, clinical teams are often shaped by professional silos and hierarchies which may hinder interprofessional collaborative practice (IPCP). Narrative medicine, a branch of health humanities that focuses on close reading, reflective writing, and sharing in groups, could be an innovative approach for improving IPE and IPCP. In this report, we describe the structure, feasibility, and a process-oriented program evaluation of a narrative medicine program implemented in interprofessional team meetings in three academic primary care clinics. Program evaluation revealed that a year-long narrative medicine program with modest monthly exposure was feasible in academic clinical settings. Staff members expressed engagement and acceptability as well as support for ongoing implementation. Program success required administrative buy-in and sustainability may require staff training in narrative medicine. Electronic supplementary material The online version of this article (10.1007/s40037-019-0497-2) contains supplementary material, which is available to authorized users.

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

“…For programmes reporting qualitative evaluations, we identified 27 as well described and 6 that were not described thoroughly. Only six NM programmes were deemed as having both quantitative and qualitative evaluation methods that were well described 49 51 52 55 77 84 85…”

“…Of quantitative programmes deemed as well described, six reported high satisfaction49 51 52 63 69 84 89 while modest and positive but not statistically significant impacts were reported on: pedagogical skills (n=2),38 85 relevance to professional work (n=1),63 resilience and burnout detection/mitigation (n=1)22 70 and confidence/increased sense of personal accomplishment (n=2) 22 38 70. Programmes that reported statistically significant programmatic impacts examined increased empathy (n=3),22 55 70 82 and increased perspective-taking/reflection (n=1) 22 70…”

“…Of qualitative programmes deemed as well described, 10 reported high satisfaction,41 42 44 45 51 52 58 69 71 72 84 85 91 while positive impacts were reported on: relationship-building (n=15),15 37 39 40 43–46 49 52 65 73 74 77 81 85 90 empathy (n=10),15 46 49 55 64 73 74 76 77 81 90 perspective-taking/reflection (n=10),37 39 40 43 52 64 73 76 77 84 85 resilience and burnout detection/mitigation (n=4),39 50 81 90 narrative competence (n=3),41 42 44 45 49 confidence/personal accomplishment (n=3),33 40 74 ethical inquiry (n=2),49 64 relevance to work (n=1),33 pedagogical skills (n=1),37 cultural competence (n=1),15 46 and institutional impact (n=1) 37…”

“…During the second screening stage, we read the full texts of records, identifying a further 109 records to exclude due to our discovering on full-text review that they did not meet our established eligibility criteria (figure 1). Following the full-text screening, 61 records qualified for review 15 22 33–89. However, we discovered that several qualifying records addressed identical NM programming efforts at the same institution: that is, 12 records15 22 41 42 44–48 52 70 84 represented 6 programmes.…”

Arts, Humanities, Medicine, and Discovery: a Creative Calling

“…4 Such endpoints as improvements in affiliation with peers and patients, self-awareness, knowledge of specific patients' situations, satisfaction with work, and sense of wellness are achieved. Individual studies assess NM's power to decrease clinician burnout, 5 to increase team cohesion, 6,7 to improve self-reflection among faculty, 8 and to perform specific interpersonally complex clinical behaviors. 9 Physicians who are interested in developing their narrative medicine skills should explore these avenues: Read widely in fiction and poetry and non-fiction, especially works by great writers.…”