Narrative in interprofessional education and practice: implications for professional identity, provider–patient communication and teamwork

Abstract

Health and social care professionals increasingly use narrative approaches to focus on the patient and to communicate with each other. Both effective interprofessional education (IPE) and practice (IPP) require recognizing the various values and voices of different professions, how they relate to the patient's life story, and how they interact with each other at the level of the healthcare team. This article analyzes and integrates the literature on narrative to explore: self-narrative as an expression of one's professional identity; the co-creation of the patient's narrative by the professional and the patient; and the interprofessional multi-vocal narrative discourse as co-constructed by members of the healthcare team. Using a narrative approach to thinking about professional identity, provider-patient communication, and interprofessional teamwork expands our thinking about both IPE and IPP by providing new insights into the nature of professional practice based on relationships to oneself, the patient, and others on the team. How professionals define themselves, gather and present information from the patient, and communicate as members of a clinical team all have important dimensions that can be revealed by a narrative approach. Implications and conclusions for the further development of the narrative approach in IPE and IPP are offered.

Emerging themes in using narrative in geriatric care: Implications for patient-centered practice and interprofessional teamwork

“…It is at this level that the individual narratives of all the different care providers must come together in a single, unified story of the patient and his or her needs (Clark, 2014). In a fundamental way, through their individual assessment stories, members of the team collaboratively co-create a care plan for the older patient that unifies their individual perspectives and ways of seeing the patient into a single voice.…”

“…The metaphor used in the narrative literature on interprofessional teamwork invokes the concept of multiple "voices" being necessary in the construction of the complete patient narrative (Clark, 2014). The "multivocality" of teamwork (Poirier, 2002) requires the incorporation of many perspectives on the patient's situation, as well as the development of dialogue and discourse on how to integrate them.…”

An interprofessional cohort analysis of student interest in medical ethics education: a survey-based quantitative study

“…Many recent studies support the integration of interactive peer-led, narrative scenarios and case-based small group formats as increasingly popular methods among student preferences to foster experiential learning and problem-solving skills [16][17][18][19][20]. This format allows students to develop practical approaches to solving common ethical dilemmas faced in Furthermore, an educational setting that takes a narrative approach and encourages dialogue specifically in an interprofessional setting has been shown to build upon the three conceptual vertical layers of professional identity, provider-patient communication and interprofessional teamwork [21]. The structure of the LTE curriculum follows this interactive, peer-led, case-based style coupled with experiential learning in medical ethics shadowing, consults and committee participation.…”

Evoking a reciprocity of caring: Integration of humanities-based content into an interprofessional education immersion course for advanced practice nursing and health professions students

“…[24,49] As a diagnostic tool, narrative becomes a method of ethical reasoning as it provides a nuanced view focused on the patient's story about health/illness situations that are context bound. [50] Patients are viewed as moral agents who enact choices based on personal values. Thus, attention to narrative is important for making care decisions that are person-centered and support the values expressed by the patient through his/her story of an illness event.…”