Narrative medicine as a teaching tool during early clinical exposure

Gaspard Aebischer

Background:

How can we help novice undergraduates be aware of the characteristics of family medicine during clinical placements? How can we encourage beginner students to develop their reflexivity from the beginning of their studies? Teaching that integrates the principles of narrative medicine can help meet these challenges.

Methods:

Upon completion of their internship in a family doctor's office, second-year bachelor students at Geneva University Medical School must produce a report on their experience. A new pilot project now offers the option to transform their report into a work of fiction. The primary requirement of this project is to narrate an encounter involving a doctor, a patient, and a trainee. Faculty members offer extra assistance to students who have made this choice to help them structure their story around the principles of narrative medicine (attention to the other, representing one's life, and thus developing a sense of affiliation) and to ensure that they include in their work the other required evaluation criteria (notably the development of a biomedical theme).

Results:

Over the past two years, ten students have chosen to write their internship report in the form of a fictional narrative. This voluntary participation has resulted in an enthusiastic commitment from the students, who have devoted a significant amount of time to writing. Most of the work they produced was of high quality, two of them receiving the faculty’s best internship report award, and several of these texts are in the process of being published. Their content demonstrates their reflexivity and their ability to understand the patient's experience.

Conclusion(s):

The use of narrative medicine, through the writing of a fictional account of an encounter between a physician, a patient, and a trainee, allows students facing their first clinical experience in a family physician's office to develop their reflexivity and their attention to the patient's experience.

Points for discussion:

How can the principles of narrative medicine, and in particular the practice of writing, serve the educational goals of family medicine?

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