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

ABSTRACT: 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 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.

SUBMITTER: Chretien KC

PROVIDER: S-EPMC4471011 | biostudies-literature | 2015 Jul

REPOSITORIES: biostudies-literature

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

Chretien Katherine C KC Swenson Rebecca R Yoon Bona B Julian Ricklie R Keenan Jonathan J Croffoot James J Kheirbek Raya R

Journal of general internal medicine 20150211 7

<h4>Background</h4>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.<h4>Aims</h4>The purpose of the study was to develop narrative competence, practice attentive listening, and stimulate reflection.<h4>Participants/se ...[more]

PMID: 25670397

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Project description:BackgroundIncorporating ultrasound into the clinical curriculum of undergraduate medical education has been limited by a need for faculty support. Without integration into the clinical learning environment, ultrasound skills become a stand-alone skill and may decline by the time of matriculation into residency. A less time intensive ultrasound curriculum is needed to preserve skills acquired in preclinical years. We aimed to create a self-directed ultrasound curriculum to support and assess students' ability to acquire ultrasound images and to utilize ultrasound to inform clinical decision-making.MethodsThird year students completed the self-directed ultrasound curriculum during their required internal medicine clerkship. Students used Butterfly iQ+ portable ultrasound probes. The curriculum included online modules that focused on clinical application of ultrasound as well as image acquisition technique. Students were graded on image acquisition quality and setting, a patient write-up focused on clinical decision-making, and a multiple-choice quiz. Student feedback was gathered with an end-of-course survey. Faculty time was tracked.ResultsOne hundred and ten students participated. Students averaged 1.79 (scale 0-2; SD = 0.21) on image acquisition, 78% (SD = 15%) on the quiz, and all students passed the patient write-up. Most reported the curriculum improved their clinical reasoning (72%), learning of pathophysiology (69%), and patient care (55%). Faculty time to create the curriculum was approximately 45 h. Faculty time to grade student assignments was 38.5 h per year.ConclusionsStudents were able to demonstrate adequate image acquisition, use of ultrasound to aid in clinical decision-making, and interpretation of ultrasound pathology with no in-person faculty instruction. Additionally, students reported improved learning of pathophysiology, clinical reasoning, and rapport with patients. The self-directed curriculum required less faculty time than prior descriptions of ultrasound curricula in the clinical years and could be considered at institutions that have limited faculty support.

Dataset Information

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

Publications

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

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