Narrative Health Care
"A scientifically competent medicine alone cannot help a patient grapple with the loss of health or find meaning in suffering. Along with scientific ability, physicians need the ability to listen to the narratives of the patient, grasp and honor their meanings, and be moved to act on the patient's behalf. This is narrative competence, that is, the competence that human beings use to absorb, interpret, and respond to stories. ... Such a medicine can be called narrative medicine." -Rita Charon (2001)
Ellen Melamed MA applies this approach in teaching medical humanities at the UA College of Medicine Tucson. She is an instructor in the UA College of Fine Arts and College of Medicine-Tucson and a playwright. She developed and initiated the first Narrative Healthcare program in Western NY at D’Youville College, and later offered workshops at Buffalo State College. She utilizes theater improvisation techniques adapted to the health care education context to guide students in developing effective communication skills.
Ellen Melamed has conducted workshops at the UA CoM entitled, Listening to Patients: An Introduction to Narrative Healthcare. She now leads the pre-clerkship curriculum on medical humanities. Recently, she began an innovative partnership with the UA Poetry Center, where she holds interactive sessions with medical students. Ms. Melamed is also publishing a book on the Alexandar Technique, "a gentle hands-on and common sense approach to learning a more efficient way to breathe and move" (Facebook Course Page). Read more...
References
Charon R. The narrative road to empathy. In: Spiro H, Curnen MGM, Peschel E, St. James D, eds. Empathy and the Practice of Medicine: Beyond Pills and the Scalpel. New Haven, Conn: Yale University Press; 1993:147-159. 4.
Charon R. Narrative medicine: form, function, and ethics. Ann Intern Med.2001;134:83-87.Google Scholar.
Reflective writing
This strategy provides an opportunity for the learner to articulate their thinking as well as to reconsider not only what they think but how they arrive at conclusions. Instructors may employ this as an exercise in a live session (e.g., Minute Paper, Med/Ed eNews, v2-07) or in preparation for small group discusssion.
At UA College of Medicine, Patricia Lebonsohn, MD, directs the health disparities curriculum during clerkship years. Students write a one-page reflection on an experience in clerkship and, after receiving a personalized response from a facilitator, share their reflections with a group of their peers. This activity provides opportunities for gleaning insight from experience and how others might perceive and learn from the experience.
References
Baruch J. Creative Writing as a Medical Instrument. J Med Humanities 34:459–469 2013.
Hammer RR, Rian JD, Gregory JK, Bostwick JM, Barrett Birk C, Chalfant L, Scanlon PD & Hall-Flavin DK. Telling the Patient's Story: Using theatre training to improve case presentation skills. J. Medical Ethics; Medical Humanities 37(1):18-22; 2011.