Group items tagged

"Narratives have always been a vital part of medicine. Stories about patients, the experience of caring for them, and their recovery from illness have always been shared-among physicians as well as among patients and their relatives. With the evolution of "modern" medicine, narratives were increasingly neglected in favor of "facts and findings," which were regarded as more scientific and objective. Now, in recent years medical narrative is changing-from the stories about patients and their illnesses, patient narratives and the unfolding and interwoven story between health care professionals and patients are both gaining momentum, leading to the creation or defining of narrative-based medicine (NBM). The term was coined deliberately to mark its distinction from evidence-based medicine (EBM); in fact, NBM was propagated to counteract the shortcomings of EBM.1,2 But what is NBM? Is it a specific therapeutic tool, a special form of physician-patient communication, a qualitative research tool, or does it simply signify a particular attitude towards patients and doctoring? It can be all of the above with different forms or genres of narrative or practical approach called for depending on the field of application. "

"The effective practice of medicine requires narrative competence, that is, the ability to acknowledge, absorb, interpret, and act on the stories and plights of others. Medicine practiced with narrative competence, called narrative medicine, is proposed as a model for humane and effective medical practice. "

"Drawing on case studies from news media to visualization research, we identify distinct genres of narrative visualization. We characterize these design differences, together with interactivity and messaging, in terms of the balance between the narrative flow intended by the author (imposed by graphical elements and the interface) and story discovery on the part of the reader (often through interactive exploration). Our framework suggests design strategies for narrative visualization, including promising under-explored approaches to journalistic storytelling and educational media."

"Narrative Medicine Rounds are lectures or readings presented by scholars, clinicians, or writers engaged in work at the interface between narrative and health care. Podcasts available on ITunes

"Seen in this light, narrative medicine appears as something rather different from a portmanteau definition covering various other schools of thought. Instead (to change the metaphor) it is more like a foundation offering moral and practical underpinning to every aspect of being a doctor. "

This document has been developed to provide practical methodological advice to reviewers who want to undertake a meta-narrative review (or synthesis - the terms are synonymous).

"In this episode, we discuss the concept of narrative medicine, what it means, its importance to medical practice and how it can help physicians become better caretakers."

"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"

early years medical students developing insights into diabetes through the use of patient narratives

Arno Kumagai,

I think this is a really interesting paper about how patient narratives can be central to medical education.

"Limited opportunities may exist for students to develop insight into the challenges faced by doctors and patients presented with challenging or sensitive illness and difficult decisions. The use of patient and doctor narratives to facilitate discussion and encourage reflection on sensitive issues can offer a useful supplement to patient contact."

"We argue that neither approach is optimal and recommend a third alternative that stresses the patient's story of illness and engages the doctor's capacity to understand, interpret and communicate the meaning of that story.2 We term this the "storied case report" in recognition of the importance of narrative to the case report."

"Limited opportunities may exist for students to develop insight into the challenges faced by doctors and patients presented with challenging or sensitive illness and difficult decisions. The use of patient and doctor narratives to facilitate discussion and encourage reflection on sensitive issues can offer a useful supplement to patient contact."

" Reflective narratives reveal how students construe professional roles in practice. Mapping the content of reflections to a competency framework confirmed the mismatch between the formal and enacted curricula. "

"COMFORT is an acronym that stands for the basic principles of palliative care communication and comprises seven modules (Communication, Orientation/Opportunity, Mindfulness, Family, Openings, Relating, Team). These communication skills training modules are designed to highlight interprofessional care and communication. Each module of the COMFORT curriculum can stand alone as a teaching activity or can be integrated into a new or existing course. Modules C (narrative clinical communication) and F (family caregivers) provide beginner level instruction, while M (mindfulness), O/O (orientation), and T (team) provide intermediate instruction and O (openings) and R (relating) provide advanced communication skills and are intended for learners who have clinical observation experience."

To explore the values and assumptions underlying problem-based learning (PBL) cases through narrative analysis, in order to consider the ways by which paper cases may affect student attitudes and values.

"The duty of the teacher in this model is not to judge and rate but, rather, to read and tell what is seen. Our teachers, having been trained in the acts of close reading, are equipped not with rating rubrics but, rather, with a reading guide that prompts the reader to attend to several narrative features of a text. The reader/coach can thereby first see and then show the writer what is contained in the written text, at least from that reader's vantage point, helping along the process not only of the writing but also of the reflection the writing birthed. Multiple readers swell and complicate the lessons learned. As a dividend, we have observed, the group of readers/writers form strong, trusting, collaborative teams. And so our training for reflection also fulfills other difficult missions of medical education in teamwork, peer learning, trust, and care."

How could this impact medical education?

Whereas present theories of transformative learning tend to focus on the rational and reflective actor, in this article it is suggested that spontaneous action may play a decisive role in transformative learning too. In the spontaneity of action, novelty finds its way into life, gains momentum, is respected by others and reflected by the actor. Such transformation processes are investigated both with the means of theoretical reflection and of empirical inquiry. Based on nine narrative interviews typical phases of transformative learning processes are identified. Owing to the comparative nature of the study, it was also possible to develop an age-related typology that overlaps certain phases of the transformation process. These empirical findings constitute the background against which the nexus of spontaneous action and transformative learning is reflected theoretically. Theories drawn upon include John Dewey's Pragmatism and George Herbert Mead's Social Pragmatism. Both scholars provide rich theoretical concepts for reflecting on the nature of that what so often eludes from the control of both educators and learners: the spontaneity of the beginning.