Narrative medicine as a medical education tool: A systematic review

Abstract

Aim: Narrative medicine has been promoted as an innovative and effective means of stimulating medical students' professional development by teaching them to approach their patients' experiences of illness with more understanding and compassion. This systematic literature review aims to answer the following question: what evidence of effect is available in the literature about models for teaching narrative medicine? Methods: We conducted a narrative review of 36 articles and used the Best Evidence in Medical Education (BEME) Global Scale and Kirkpatrick Scale for strength and importance of evidence to categorize reported assessment strategies and to evaluate the effectiveness of their narrative medicine programs. Results: We found evidence that narrative medicine is an effective pedagogic tool with a clear and replicable structure and methodology. We also determined that a positive impact could be measured when pertaining to participation and modification of attitudes, knowledge, and skills. However, unequivocal evidence of the effect of narrative medicine on students' behavior or ongoing interaction with colleagues and patients is still lacking. Conclusion: While many recent publications describe the goals and virtues of a narrative-based approach, more research is needed to determine whether or not there is an ideological consensus undergirding this approach. In addition, it is still unclear whether the long-term impact of narrative medicine classroom interventions are felt by patients, or whether such interventions positively impact patient care.

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

“…Whereas previous systematic reviews have concluded that NM education may be beneficial in contributing to compassionate care,24 enhanced empathy25 29 and effective teaching,28 our research builds on the current literature to reveal a broad range of NM benefits. Our findings demonstrate that NM has shown potential for enhancing communication and team-building skills, encouraging perspective-taking and reflection, promoting empathic behaviour, detecting/mitigating burnout, cultivating narrative competence, augmenting pedagogical and clinical skills, and fostering ethical inquiry.…”

“…Lasko et al considered narrative interventions within the specific setting of palliative care and recommended the adoption of more consistency across pedagogical frameworks and potential outcomes 27. Milota et al investigated the use of NM as an educational tool for medical students and concluded that, while NM comprises an effective teaching strategy, more research is needed to determine its long-term impact 28. Finally, Schoonover et al found that poetry, a component of NM, may increase empathy and reduce burnout among healthcare professionals 29…”

A qualitative study of clinical narrative competence of medical personnel

“…However, in order to provide holistic medical care, it is necessary to take into account the psychosocial aspects, in addition to the disease, the family and social cultural context, the patient’s spiritual beliefs, and the other impacts of medical care decisions. As the role of digital technology in clinical medicine becomes more important, less attention was paid to the personal narrative from the patient’s subjective experience [ 12 ]. Therefore, medical personnel need to have appropriate “narrative competence” as well as medical-related knowledge.…”

Storytelling in Medical Education: Narrative Medicine as a Resource for Interdisciplinary Collaboration

“…Healthcare providers may lose an empathetic connection with patients and patients' families [5,6]. In order to address the phenomenon of ethical erosion, narrative medicine can be used as an innovative tool to stimulate healthcare students' and providers' professionalism by letting them approach illness narratives with more empathetic connection and understanding [7]. It is medicine that uses narrative competence in diagnostic encounters and therapeutic processes to arouse empathy and understanding among physician, patients, patients' families, therapists, medical technologists, and other healthcare professionals [8,9].…”