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Palla I, Turchetti G, Polvani S. Narrative Medicine: theory, clinical practice and education - a scoping review. BMC Health Serv Res 2024; 24:1116. [PMID: 39334149 DOI: 10.1186/s12913-024-11530-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 09/03/2024] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND The origin of Narrative Medicine dates back to more than 20 years ago at an international level. Narrative Medicine is not an alternative to evidence-based medicine, however these two approaches are integrated. Narrative Medicine is a methodology based on specific communication skills where storytelling is a fundamental tool to acquire, understand and integrate several points of view related to persons involving in the disease and in the healthcare process. Narrative Medicine, henceforth NM, represents a union between disease and illness between the doctor's clinical knowledge and the patient's experience. According to Byron Good, "we cannot have direct access to the experience of others' illness, not even through in-depth investigations: one of the ways in which we can learn more from the experience of others is to listen to the stories of what has happened to other people." Several studies have been published on NM; however, to the best of our knowledge, no scoping review of the literature has been performed. OBJECTIVE This paper aims to map and synthetize studies on NM according to theory, clinical practice and education/training. METHOD The scoping review was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) checklist. A search was conducted in PubMed, APA PsycNet and Jstor. Two authors independently assessed the eligibility and methodological quality of the studies and extracted the data. This review refers to the period from 1998 to 2022. RESULTS A total of 843 abstracts were identified of which 274 papers were selected based on the title/abstract. A total of 152 papers in full text were evaluated and 76 were included in the review. Papers were classified according to three issues: ✘ Nineteen studies focused on the definition and concept of NM (Theoretical). ✘ Thirty-eight papers focused on the collection of stories, projects and case reports (Clinical practice). ✘ Nineteen papers focused on the implementation of the Narrative Medicine approach in the education and training of medical doctors (Education and training). CONCLUSIONS This scoping review presents an overview of the state of the art of the Narrative Medicine. It collect studies performed mainly in Italy and in the United States as these are the countries developing the Narrative Medicine approach in three identified areas, theoretical, clinical practice and education and training. This scoping review will help to promote the power of Narrative Medicine in all three areas supporting the development of methods to evaluate and to measure the Narrative Medicine approach using key performance indicators.
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Affiliation(s)
- Ilaria Palla
- Institute of Management, Scuola Superiore Sant'Anna Pisa, Piazza Martiri della Libertà 33, Pisa, 56127, Italy.
| | - Giuseppe Turchetti
- Institute of Management, Scuola Superiore Sant'Anna Pisa, Piazza Martiri della Libertà 33, Pisa, 56127, Italy
| | - Stefania Polvani
- SIMeN, Società Italiana Medicina Narrativa, Arezzo, Italy
- Azienda USL Toscana Sud Est, Arezzo, Italy
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Paul TK, Reddy Y, Gnanakumar A, England R, Superdock A, Malipeddi D, Wrigley J, Reardon E, Weaver MS, Kaye EC. Narrative medicine interventions for oncology clinicians: a systematic review. Support Care Cancer 2024; 32:241. [PMID: 38512594 DOI: 10.1007/s00520-024-08434-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 03/11/2024] [Indexed: 03/23/2024]
Abstract
PURPOSE As narrative medicine interventions are integrated increasingly into medical practice, growing evidence indicates benefits for healthcare professionals. Presently, the prevalence and impact of narrative medicine interventions in the field of oncology remain unknown. This systematic review synthesizes published data on narrative medicine interventions in oncology and reports current knowledge on feasibility, acceptability, and impact on cancer care professionals. METHODS Following PRISMA guidelines, we searched Ovid Medline, Embase, Scopus, Web of Science, Cochrane, and ClinicalTrials.gov databases from inception through February 2024. Eligible articles were published in English and contained original data on feasibility, acceptability, and/or impact of a narrative medicine intervention for oncology professionals. Database searches identified 2614 deduplicated articles, from which 50 articles were identified for full-text assessment and 11 articles met inclusion criteria. Two additional articles were identified through manual review of references. RESULTS Thirteen articles described 12 unique narrative medicine interventions targeting cancer care professionals. All studies described their respective interventions as feasible, acceptable, and impactful for participants. Interventions involved writing, reading, reflection, and other narrative-based strategies. Standardized validated tools evaluated outcomes including burnout, empathy expression, secondary trauma, quality of humanistic care, and well-being. Participants reported appreciation of opportunities for reflection, perspective sharing, and bearing witness, which they perceived to strengthen wellness and community. CONCLUSION Narrative medicine interventions are feasible and acceptable and may bolster oncology clinicians' functioning across domains. Multi-site, prospective, randomized studies are needed to investigate the broader impact of narrative medicine interventions and advance the science of narrative medicine in oncology. TRIAL REGISTRATION ClinicalTrials.gov Identifier: CRD42022369432.
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Affiliation(s)
- Trisha K Paul
- Department of Oncology, Division of Quality of Life and Palliative Care, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Mail Stop 260, Memphis, TN, USA.
| | | | | | - Rebecca England
- University of Tennessee Health Science Center, Memphis, TN, USA
| | - Alexandra Superdock
- Department of Oncology, Division of Quality of Life and Palliative Care, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Mail Stop 260, Memphis, TN, USA
| | | | - Jordan Wrigley
- Department of Oncology, Division of Quality of Life and Palliative Care, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Mail Stop 260, Memphis, TN, USA
| | | | | | - Erica C Kaye
- Department of Oncology, Division of Quality of Life and Palliative Care, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Mail Stop 260, Memphis, TN, USA
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Epner DE, Reddy SK, Hui D, Fellman B, Bruera E. Doing the hard work of learning: oncologists' enduring impressions of a year-long communication skills training program. Support Care Cancer 2023; 32:71. [PMID: 38158427 DOI: 10.1007/s00520-023-08285-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 12/19/2023] [Indexed: 01/03/2024]
Abstract
PURPOSE Few studies have examined the long-term impact of communication skills training for oncologists. We developed a year-long communication skills curriculum for medical oncology fellows with the primary goals of fostering life-long learning of patient-centered communication skills and internalization of associated attitudes and beliefs. We engaged learners through reflection, narrative methods, and action methods, thereby creating a non-threatening, team-based environment. The purpose of the current study was to determine whether learners perceived that they had acquired enduring skills, attitudes, and knowledge years after they participated. METHODS Former fellows completed an online cross-sectional survey from June to July 2019 that included demographic information, 21 items on a numerical scale, and 3 narrative prompts. Survey items pertained to 4 domains, including skills, attitudes, confidence with specific scenarios, and overall impressions. The numerical scale ranged from "strongly agree" = 1 to "strongly disagree" = 5. RESULTS A total of 114 fellows, including 27 teaching assistants, participated in the communication skills training over 8 years. The average time between the end of the training program and completion of the survey was 5.2 years. The response rate was 68/114 (64%). Forty-one (60%, 95% CI: 49.3-73.8) fellows agreed or strongly agreed that the curriculum profoundly impacted their practice of medicine. Forty-three (64%, 95% CI: 51.5-75.5) fellows strongly agreed or agreed that they often found themselves informally sharing lessons they learned during the series. Overall average domain scores were 1.89 (SD = 0.84) for skills, 2.16 (0.79) for attitudes, 2.05 (0.81) for confidence with specific challenges, and 2.38 (0.94) for lasting impressions. Results were significantly more favorable for teaching assistants than for others. CONCLUSION Engaging, interactive, safe, and learner-centered communication skills training has an enduring and favorable impact on oncologists' self-perceived skills, confidence with specific challenges, and attitudes.
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Affiliation(s)
- Daniel E Epner
- Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, 1400 Pressler, Unit 1414, Houston, TX, 77030, USA.
| | - Suresh K Reddy
- Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, 1400 Pressler, Unit 1414, Houston, TX, 77030, USA
| | - David Hui
- Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, 1400 Pressler, Unit 1414, Houston, TX, 77030, USA
| | - Bryan Fellman
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd. / Unit 1411, Houston, TX, 77030, USA
| | - Eduardo Bruera
- Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, 1400 Pressler, Unit 1414, Houston, TX, 77030, USA
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Wall NR, Fuller RN, Morcos A, De Leon M. Pancreatic Cancer Health Disparity: Pharmacologic Anthropology. Cancers (Basel) 2023; 15:5070. [PMID: 37894437 PMCID: PMC10605341 DOI: 10.3390/cancers15205070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/17/2023] [Accepted: 10/18/2023] [Indexed: 10/29/2023] Open
Abstract
Pancreatic cancer (PCa) remains a formidable global health challenge, with high mortality rates and limited treatment options. While advancements in pharmacology have led to improved outcomes for various cancers, PCa continues to exhibit significant health disparities, disproportionately affecting certain populations. This paper explores the intersection of pharmacology and anthropology in understanding the health disparities associated with PCa. By considering the socio-cultural, economic, and behavioral factors that influence the development, diagnosis, treatment, and outcomes of PCa, pharmacologic anthropology provides a comprehensive framework to address these disparities and improve patient care.
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Affiliation(s)
- Nathan R. Wall
- Division of Biochemistry, Department of Basic Science, Center for Health Disparities and Molecular Medicine, Loma Linda University, Loma Linda, CA 92350, USA; (R.N.F.); (A.M.)
| | - Ryan N. Fuller
- Division of Biochemistry, Department of Basic Science, Center for Health Disparities and Molecular Medicine, Loma Linda University, Loma Linda, CA 92350, USA; (R.N.F.); (A.M.)
| | - Ann Morcos
- Division of Biochemistry, Department of Basic Science, Center for Health Disparities and Molecular Medicine, Loma Linda University, Loma Linda, CA 92350, USA; (R.N.F.); (A.M.)
| | - Marino De Leon
- Division of Physiology, Department of Basic Science, Center for Health Disparities and Molecular Medicine, Loma Linda University, Loma Linda, CA 92350, USA;
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Rivest J, Karazivan P, Desbeaumes Jodoin V, Flora L, Lambert C, Tranulis C, Daneault S. Listening to Cancer Patients' Narratives During Residency: A Pilot Study on a Communication Skills' Workshop Involving Patients-Partners. J Patient Exp 2023; 10:23743735231183674. [PMID: 37441277 PMCID: PMC10334025 DOI: 10.1177/23743735231183674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/15/2023] Open
Abstract
The field of cancer care still lacks best practices in communication. Few postgraduate training programs offer formal training to develop such skills. The patient partnership has been used in medical education to increase the sensitivity of the subjective experiences of patients. In our Canadian center, residents and patient-partners participated in an educational workshop on communication focusing on patient's narrative. The aim of this pilot qualitative study was to explore the experiences of participants in the workshop. Using theoretical sampling, we recruited 6 residents and 6 patient-partners. Semi-structured interviews were conducted and transcribed. A thematic analysis was performed. From analysis, 4 themes emerged: (1) lack of communication skills training; (2) barriers to effective communication in cancer care; (3) the empathy of patient-partners towards the communication challenges faced by residents; and (4) the participants' reactions to the workshop. Based on our findings, our communication skills workshop centered on narrative medicine and involving patient-partners appears feasible. Future research could study its pedagogical value and the optimal learning environment required.
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Affiliation(s)
- Jacynthe Rivest
- Department of Psychiatry, Centre
Hospitalier de l'Université de Montréal (CHUM), Montreal, Canada
- Centre de Recherche du Centre
Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Canada
| | - Philippe Karazivan
- Department of Family Medicine,
University of Montreal Faculty of Medicine, Montreal, Canada
- Center of Excellence for Partnership
with Patients and the Public, University of Montreal, Montreal, Quebec, Canada
| | - Véronique Desbeaumes Jodoin
- Department of Psychiatry, Centre
Hospitalier de l'Université de Montréal (CHUM), Montreal, Canada
- Centre de Recherche du Centre
Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Canada
| | - Luigi Flora
- Center of Excellence for Partnership
with Patients and the Public, University of Montreal, Montreal, Quebec, Canada
- Innovation Center for partnership with
patients and the public, Côte d’Azur University, Clermont-Ferrand, France
| | - Carole Lambert
- Centre de Recherche du Centre
Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Canada
- Department of Radiation Oncology,
University of Montreal Health Center, Montreal, Canada
| | - Constantin Tranulis
- Institut universitaire en santé mentale
de Montréal, Montreal, Quebec, Canada
| | - Serge Daneault
- Department of Family Medicine,
University of Montreal Faculty of Medicine, Montreal, Canada
- Centre de recherche de l’Institut
universitaire de gériatrie de Montréal, Montreal, Canada
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Dutt H, Dean A, Kamal RS, Allan AL. Importance of Incorporating the Perspectives of People with Cancer into Oncology Education: A Scoping Review. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2023; 10:23821205231219394. [PMID: 38116493 PMCID: PMC10729629 DOI: 10.1177/23821205231219394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 11/17/2023] [Indexed: 12/21/2023]
Abstract
Background With the shift towards person-centered care (PCC) in oncology, there is a need for parallel evolution of oncology education programs to prepare the next generation of health professionals to deliver effective PCC. These programs should be designed utilizing perspectives from individuals who have lived experience with cancer to ensure that changes to education curricula translate to improved PCC in the clinic. Objectives Our goal was to identify existing literature describing such programs as well as identify gaps for further development. Methods Keywords were agreed upon and searched across Ovid Medline, Ovid Embase, ERIC, Google Scholar, and MedEdPORTAL databases. Duplicates were removed, unique articles were screened for relevance by title and abstract, and a full text review of each article was completed for validation. Included articles describe methods for involving people with cancer in developing and/or delivering oncology-focused education programs. Results In total, 15 articles describing 12 unique oncology education programs from 7 different countries were identified, reviewed, and summarized. These programs involved learners undertaking undergraduate medical education, postgraduate medical education, continuing medical education, or training as nurses or radiation therapists. Current literature indicates that classroom-based sessions, experiential or simulated learning modalities, and/or asynchronous online modules can all feasibly be created with the integration of perspectives/narratives of people with cancer. Furthermore, involving people with cancer directly in the design and/or delivery of these education programs may contribute to improved patient experiences. Conclusions Including the perspectives of people with cancer directly in oncology curriculum development and delivery can improve established pedagogical approaches and enhance learner confidence and competency in delivering PCC. We provide recommendations for stepwise implementation of patient perspectives into oncology education, with the hope that future programs will better prepare and motivate learners to provide PCC aimed at improving cancer care, quality of life, and disease outcomes.
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Affiliation(s)
- Hanna Dutt
- London Regional Cancer Program, London Health Sciences Centre, London, Ontario, Canada
- Interdisciplinary Medical Sciences Program, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Arleigh Dean
- London Regional Cancer Program, London Health Sciences Centre, London, Ontario, Canada
- Interdisciplinary Medical Sciences Program, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Rayyan Syed Kamal
- London Regional Cancer Program, London Health Sciences Centre, London, Ontario, Canada
- Interdisciplinary Medical Sciences Program, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Alison L. Allan
- London Regional Cancer Program, London Health Sciences Centre, London, Ontario, Canada
- Department of Anatomy & Cell Biology, and Department of Oncology, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
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Sagin A, Ellman MS, Shariff RR, Jones CA, Tindall K, Siropaides CH. A Multicenter Qualitative Analysis of Medical Student Narratives After a Palliative Care Elective. Am J Hosp Palliat Care 2020; 38:1126-1134. [PMID: 33143465 DOI: 10.1177/1049909120971565] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The medical student experience of a clinical elective in palliative care (PC) remains understudied. Reflective narrative interventions can help students hone narrative competency skills, make sense of their clinical experiences and shed light on their perception of the rotation. OBJECTIVES To evaluate medical student written reflections after a PC clinical elective. DESIGN Students were asked to write a short reflective essay after PC clinical electives using open-ended writing prompts. SETTING Essays were collected from third and fourth-year medical students after completion of a PC elective at three geographically diverse academic medical centers in the United States. MEASUREMENTS Essays were coded for themes using a conventional content qualitative method of analysis. RESULTS Thirty-four essays were analyzed and four major themes emerged: reflection on the mission of medicine or motivation for being in medicine, reflection on professional skills or lessons learned, reflection on patient's experience and personal responses to PC rotation. Sub-themes were also identified. CONCLUSIONS Themes underscore the utility of the PC clinical elective as a meaningful experience that imparts useful skills, builds empathy, reminds students of their own motivations for being in medicine and serves as a catalyst for reflection on their own lives and relationships with their patients. Awareness of medical students' personal and emotional responses to a PC elective can help inform educators as they support their students and provide opportunities for reflection and education.
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Affiliation(s)
- Alana Sagin
- Palliative Care Program, Department of Medicine, 6569University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Matthew S Ellman
- Department of Internal Medicine, 12228Yale School of Medicine, New Haven, CT, USA
| | - Ruhi R Shariff
- Palliative Care Program, 12245Rush Medical College, Chicago, IL, USA
| | - Christopher A Jones
- Section of Palliative Care, 12277Duke University School of Medicine, Durham, NC, USA
| | - Kate Tindall
- Section of Supportive and Palliative Medicine, Department of Medicine, 25989UT Southwestern Medical School, Dallas, TX, USA
| | - Caitlin H Siropaides
- Section of Supportive and Palliative Medicine, Department of Medicine, 25989UT Southwestern Medical School, Dallas, TX, USA
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Su T, He C, Li X, Xiao L, He J, Bai Y, Tang Y. Association between early informed diagnosis and survival time in patients with lung cancer. Psychooncology 2020; 29:878-885. [PMID: 32266740 DOI: 10.1002/pon.5360] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 01/07/2020] [Accepted: 02/10/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE As a malignant tumor with high mortality, lung cancer (LC) often causes great trauma to patients, and a series of negative emotions and a heavy psychological burden accompanies poor prognosis. Whether or not to inform the patients of their condition has always been a controversial topic in the medical community. This retrospective cohort study investigated the association between early informed diagnosis and survival time in patients with LC. METHODS A total of 29 825 patients with LC were enrolled between October 2002 and December 2016. The potential factors influencing LC survival were registered, including knowing their cancer diagnosis status, age, gender, pathological type, clinical stage, surgical history, hospital grade, and patient occupation. All participants were followed up every 6 months until June 2017. RESULTS In June 2017, 23.1% of the participants still survived. Their median survival time (MST) was 11.20 months (95% confidence interval [CI], 10.98-11.43). Generally, patients that knew their cancer diagnosis had longer MST than those who did not (18.33 months vs 8.77 months, P < .001). By stratified analysis, patients that knew their cancer diagnosis had longer survival time in each subgroup (P < .001, all subgroups). Cox regression analysis showed that knowing their cancer diagnosis was an independent influencing factor for survival in patients with LC (hazard ratio, 0.826; 95% CI, 0.802-0.851; P < .001). CONCLUSIONS Knowing their cancer diagnosis contributed to longer survival time in patients with LC, providing clear evidence that medical staff and patients' families should fully disclose cancer diagnoses to patients.
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Affiliation(s)
- Tong Su
- College of Psychology, The Second Military Medical University, Shanghai, China.,Department of Medical Psychology, Changzheng Hospital Affiliated to the Second Military Medical University, Shanghai, China
| | - Chen He
- College of Psychology, The Second Military Medical University, Shanghai, China
| | - Xiaopan Li
- Department of Cancer Prevention and Vital Statistics, Center for Disease Control and Prevention, Shanghai, China.,Pudong Institute of Preventive Medicine, Fudan University, Shanghai, China
| | - Lei Xiao
- College of Psychology, The Second Military Medical University, Shanghai, China
| | - Jingwen He
- College of Psychology, The Second Military Medical University, Shanghai, China
| | - Yonghai Bai
- Department of Medical Psychology, Changzheng Hospital Affiliated to the Second Military Medical University, Shanghai, China
| | - Yunxiang Tang
- College of Psychology, The Second Military Medical University, Shanghai, China.,Department of Medical Psychology, Changzheng Hospital Affiliated to the Second Military Medical University, Shanghai, China
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Remein CD, Childs E, Pasco JC, Trinquart L, Flynn DB, Wingerter SL, Bhasin RM, Demers LB, Benjamin EJ. Content and outcomes of narrative medicine programmes: a systematic review of the literature through 2019. BMJ Open 2020; 10:e031568. [PMID: 31988222 PMCID: PMC7045204 DOI: 10.1136/bmjopen-2019-031568] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 11/23/2019] [Accepted: 12/02/2019] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES Narrative medicine (NM) incorporates stories into health sciences paradigms as fundamental aspects of the human experience. The aim of this systematic review is to answer the research question: how effective is the implementation and evaluation of NM programmes in academic medicine and health sciences? We documented objectives, content and evaluation outcomes of NM programming to provide recommendations for future narrative-based education. METHODS We conducted a systematic review of literature published through 2019 using five major databases: PubMed, Embase, PsycINFO, ERIC and MedEdPORTAL. Eligible NM programming included textual analysis/close reading of published literature and creative/reflective writing. Qualifying participants comprised individuals from academic medicine and health sciences disciplines. We reviewed and categorised programme goals, content and evaluation activities to assess participant satisfaction and programme efficacy. Two members of the research team assessed the risk of bias, independently screening records via a two-round, iterative process to reach consensus on eligibility. RESULTS Of 1569 original citations identified, we selected 55 unique programmes (described in 61 records). In all, 41 (75%) programmes reported a form of evaluation; evaluation methods lacked consistency. Twenty-two programmes used quantitative evaluation (13 well described), and 33 programmes used qualitative evaluation (27 well described). Well-described quantitative evaluations relied on 32 different measures (7 validated) and showed evidence of high participant satisfaction and pre-post improvement in competencies such as relationship-building, empathy, confidence/personal accomplishment, pedagogical skills and clinical skills. An average of 88.3% of participants agreed or strongly agreed that the programme had positive outcomes. Qualitative evaluation identified high participant satisfaction and improvement in competencies such as relationship-building, empathy, perspective-taking/reflection, resilience and burnout detection/mitigation, confidence/personal accomplishment, narrative competence, and ethical inquiry. CONCLUSION Evaluation suggests that NM programming leads to high participant satisfaction and positive outcomes across various competencies. We suggest best practices and innovative future directions for programme implementation and evaluation.
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Affiliation(s)
| | - Ellen Childs
- Boston University School of Public Health, Boston, Massachusetts, USA
| | - John Carlo Pasco
- Boston University School of Medicine, Boston, Massachusetts, USA
| | - Ludovic Trinquart
- Boston University School of Public Health, Boston, Massachusetts, USA
| | - David B Flynn
- Boston University School of Medicine, Boston, Massachusetts, USA
| | | | - Robina M Bhasin
- Boston University School of Medicine, Boston, Massachusetts, USA
| | - Lindsay B Demers
- Boston University School of Medicine, Boston, Massachusetts, USA
| | - Emelia J Benjamin
- Boston University School of Medicine, Boston, Massachusetts, USA
- Boston University School of Public Health, Boston, Massachusetts, USA
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Daryazadeh S, Yamani N, Adibi P. Development of a checklist to validate the framework of a narrative medicine program based on Gagne's instructional design model in Iran through consensus of a multidisciplinary expert panel. JOURNAL OF EDUCATIONAL EVALUATION FOR HEALTH PROFESSIONS 2019; 16:34. [PMID: 31805625 PMCID: PMC6895376 DOI: 10.3352/jeehp.2019.16.34] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 10/31/2019] [Indexed: 05/29/2023]
Abstract
PURPOSE Narrative medicine is a patient-centered approach focusing on the development of narrative skills and self-awareness that incorporates "attending, representing, and affiliating" in clinical encounters. Acquiring narrative competency promotes clinical performance, and narratives can be used for teaching professionalism, empathy, multicultural education, and professional development. This study was conducted to develop a checklist to validate the framework of a narrative medicine program through consensus of a panel. METHODS This expert panel study was conducted from 2018 to 2019 at Isfahan University of Medical Sciences, Iran. It included 2 phases: developing a framework in 2 steps and forming an expert panel to validate the framework in 3 rounds. We adapted a 3-stage narrative medicine model with 9 training activities from Gagne's theory, developed a framework, and then produced a checklist to validate the framework in a multidisciplinary expert panel that consisted of 7 experts. The RAND/UCLA appropriateness method was used to assess the experts' agreement. The first-round opinions were received by email. Consensus was achieved in the second and third rounds through face-to-face meetings to facilitate interactions and discussion among the experts. RESULTS Sixteen valid indicators were approved and 100% agreement was obtained among experts (with median values in the range of 7-9 out of a maximum of 9, with no disagreement), and the framework was validated by the expert panel. CONCLUSION The 16 checklist indicators can be used to evaluate narrative medicine programs as a simple and practical guide to improve teaching effectiveness and promote life-long learning.
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Affiliation(s)
- Saeideh Daryazadeh
- Department of Medical Education and Medical Education Research Center, Medical Education Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nikoo Yamani
- Department of Medical Education and Medical Education Research Center, Medical Education Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Payman Adibi
- Department of Medical Education and Medical Education Research Center, Medical Education Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Internal Medicine, Research Center of Gastroenterology, Isfahan University of Medical Sciences, Isfahan, Iran
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