Chretien Katherine C, Swenson Rebecca, Yoon Bona, Julian Ricklie, Keenan Jonathan, Croffoot James, Kheirbek Raya
Washington DC Veterans Affairs Medical Center, 50 Irving Street, NW, Medical Service (111), Washington, DC, 20422, USA,
J Gen Intern Med. 2015 Jul;30(7):1025-8. doi: 10.1007/s11606-015-3211-z. Epub 2015 Feb 11.
Narrative medicine educational interventions may enhance patient-centered care, yet most educational interventions do not involve actual patient-provider interactions, nor do they assess narrative competence, a key skill for its practice. An experiential narrative medicine curriculum for medical students was developed and piloted.
The purpose of the study was to develop narrative competence, practice attentive listening, and stimulate reflection.
PARTICIPANTS/SETTING: Participants were third-year medicine clerkship students.
The curriculum involved 1) an introductory session, 2) a patient storytelling activity, and 3) a group reflection session. For the storytelling activity, students elicited illness narratives in storytelling form from patients, listened attentively, wrote their versions of the story, and then read them back to patients.
Five student focus groups were conducted between July 2011 and March 2012 (n = 31; 66%) to explore students' experiences, student-patient dynamics, challenges, and what they learned. Patient interviews (n = 17) on their experience were conducted in January 2013. Thematic analysis of the audiotaped stories of ten patients and corresponding student-written stories helped gauge narrative competence.
The curriculum was found to be feasible and acceptable to both patients and students. Some patients and students were profoundly moved. Ongoing focus groups resulted in continual process improvement. Students' stories showed attainment of narrative competence.
叙事医学教育干预可能会增强以患者为中心的医疗服务，但大多数教育干预并不涉及实际的医患互动，也不评估叙事能力，而叙事能力是其实践的一项关键技能。针对医学生开发并试行一种体验式叙事医学课程。
本研究的目的是培养叙事能力、练习专注倾听并激发反思。
参与者/背景：参与者为医学三年级见习学生。
该课程包括1）一次入门课程、2）一次患者故事讲述活动以及3）一次小组反思课程。在故事讲述活动中，学生以故事形式从患者那里引出疾病故事，认真倾听，撰写自己版本的故事，然后读给患者听。
在2011年7月至2012年3月期间进行了五次学生焦点小组讨论（n = 31；66%），以探索学生的经历、医患互动、挑战以及他们所学的内容。2013年1月对患者进行了关于其经历的访谈（n = 17）。对十名患者的录音故事及相应的学生撰写故事进行主题分析，以评估叙事能力。
发现该课程对患者和学生而言都是可行且可接受的。一些患者和学生深受感动。持续进行的焦点小组讨论促使课程不断改进。学生的故事表明他们获得了叙事能力。
