Narrative medicine as a means of training medical students toward residency competencies

Abstract

Objective This study sought to explore the perceived influence of narrative medicine training on clinical skill development of fourth-year medical students, focusing on competencies mandated by ACGME and the RCPSC in areas of communication, collaboration, and professionalism. Methods Using grounded-theory, three methods of data collection were used to query twelve medical students participating in a one-month narrative medicine elective regarding the process of training and the influence on clinical skills. Iterative thematic analysis and data triangulation occurred. Results Response rate was 91% (survey), 50% (focus group) and 25% (follow-up). Five major findings emerged. Students perceive that they: develop and improve specific communication skills; enhance their capacity to collaborate, empathize, and be patient-centered; develop personally and professionally through reflection. They report that the pedagogical approach used in narrative training is critical to its dividends but misunderstood and perceived as counter-culture. Conclusion/Practice implications Participating medical students reported that they perceived narrative medicine to be an important, effective, but counter-culture means of enhancing communication, collaboration, and professional development. The authors contend that these skills are integral to medical practice, consistent with core competencies mandated by the ACGME/RCPSC, and difficult to teach. Future research must explore sequelae of training on actual clinical performance.

Implementing a Narrative Medicine Curriculum During the Internship Year: An Internal Medicine Residency Program Experience

“…Narrative medicine also can help medical students meet Accreditation Council for Graduate Medical Education competencies, including interpersonal and communication skills and professionalism. 10,11 Medical students respond favorably to narrative medicine curricula. 6,10 However, little is known about the benefits of a narrative medicine curriculum during residency training and thereafter.…”

“…10,11 Medical students respond favorably to narrative medicine curricula. 6,10 However, little is known about the benefits of a narrative medicine curriculum during residency training and thereafter. 12 Few structured efforts encouraging narrative medicine during residency training exist even though narrative skills are essential to ensure effective physician-patient and physician-physician communication.…”

“…A 2013 study discussed resistance among faculty and residents who were unfamiliar with narrative medicine and cited this lack of knowledge as a barrier to implementation. 10 Nevertheless, opportunities exist within training to provide residents with the opportunity to engage in narrative and reflection activities. These opportunities include implementing activities during residents' protected time (morning report or noon conference), using in-house resources (building space, library, and art displays), and encouraging residents to participate in unfamiliar activities.…”

Tell Me Your Story: A Pilot Narrative Medicine Curriculum During the Medicine Clerkship

“…2,4,5 Educators have used narrative medicine approaches such as illness narrative-writing exercises as a method to teach empathy, patient-centeredness, and humanism. [5][6][7][8][9] Most published educational interventions have occurred during the preclinical years of medical school, outside actual patient-provider interactions. Furthermore, we are not aware of any studies that have addressed narrative competence skills.…”

Narrativa da Doença: Uma Disciplina Optativa na Faculdade de Medicina de Lisboa

“…O conceito de Medicina Narrativa é mais do que uma disciplina, é uma área de comunicação, colaboração e profissionalismo que exige treino na prática médica e capacidades de relacionamento interpessoal, ético, interpretativo e reflexivo. 7,8 O docente clínico deve ter formação na área e ser o modelo na forma como colhe uma história clínica e no relacionamento com o doente e a família.…”