Storytelling in Medical Education: Narrative Medicine as a Resource for Interdisciplinary Collaboration
Abstract
:1. Introduction
1.1. Narrative Medicine and Literature Study
1.2. Reflective Thinking
1.3. Interdisciplinary Collaboration
2. Materials and Methods
2.1. Participants
2.2. Experimental Design
2.3. Cluster Algorithm for Interdisciplinary Collaboration
2.4. Procedure
2.5. Measures, Validity, and Reliability
2.5.1. Reflective Thinking Scale for Healthcare Students and Providers (RTS-HSP)
2.5.2. Patient–Healthcare Provider Communication Scale (P-HCS)
2.5.3. Empathy Scale in Patient Care (ES-PC)
2.5.4. Analytic Narrative Medicine Writing Scoring Rubric (ANMWSR)
2.6. Data Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Group | Experimental Group | Control Group | |
---|---|---|---|
Cluster Number | |||
1 | 5, 15, 17. 21 | 4, 14, 15, 21 | |
2 | 7, 9, 23, 25 | 9, 16, 22, 25 | |
3 | 3, 12, 19, 22 | 6, 7, 12, 17 | |
4 | 4, 8, 10, 27 | 3, 20, 27, 30 | |
5 | 6, 16, 24, 28 | 1, 11, 19, 26 | |
6 | 2, 13, 31, 33, | 10, 18, 23, 28 | |
7 | 1, 14, 18, 20 | 5, 8, 24, 31 | |
8 | 11, 26, 29, 30, 32 | 2, 13, 29, 32 |
Week | Course Content and Discussion Topics |
---|---|
1–2 | Keywords & Lecturing: medical humanities; empathy versus compassion; professionalism; medical professionalism; narrations and story telling Teaching Content: introduction to medical humanities; literature and medicine; medicine as art or as science; How can art and humanities help facilitate communication, understanding, and empathy? Literature Study: “Heart-wrenching photo of doctor crying goes viral. Here’s why” [28] Conflicts & Dilemmas: Do you think healthcare professionals should show appropriate compassion and empathy towards patients? Can doctors cry? Why or why not? |
3–5 | Keywords & Lecturing: terminal cancer; DNR (Do Not Resuscitate) option; dying with dignity; human interaction; doctor–patient relationship; medical team; human beings versus research objects Literature Study: Wit: A play [29]; Wit [30] Conflicts & Dilemmas: Do you think patients have the right to choose the DNR option once they are ready to die? Do you think only God alone has the right to terminate life? Why or why not? |
6–7 | Keywords & Lecturing: rest cure versus writing cure; doctor husband versus doctor’s wife; female voice; marginalized community; narrators; madness Literature Study: The Yellow Wallpaper [31] Conflicts & Dilemmas: Do you think it is better to go on a rest cure or writing cure after childbirth? Do you think women (women, or both genders) are oppressed under the patriarchal society? Are you willing to marry a doctor husband? Why or why not? |
8–10 | Keywords & Lecturing: Alzheimer’s disease; aging; physician husband; empathy versus detachment; self-killing/suicide; life value and dignity. Literature Study: Still Alice [32]; Still Alice [33] Conflicts & Dilemmas: In your opinion, what is the definition of “aging”? Do you think the government should make a policy to stop medical treatment for the aging and “useless eaters”? |
11–12 | Keywords & Lecturing: female subjectivity; soul freedom/release; meaning in life; identity recognition; depression and mental illness Literature Study: To Room Nineteen [34] Conflicts & Dilemmas: Do you think women should be financially independent or dependent upon men; Do you think it is morally acceptable to commit suicide if one decides life is meaningless or if one finds their heath is unrecoverable? Why or why not? |
13–15 | Keywords & Lecturing: trauma; domestic violence; sacrifice versus contribution; marginalized community; born good versus born evil Literature Study: Pay It Forward [35]; Pay It Forward [36] Conflicts & Dilemmas: Do you think people are basically good or evil? Do you want to “pay it forward”? Why or why not? |
Test | Covariance | |||
---|---|---|---|---|
Posttest | Reflective skepticism (pretest) | Self-examination (pretest) | Empathetic reflection (pretest) | Critical open-mindedness (pretest) |
Wilk’s Λ F (4, 56) (p-value) | ||||
0.766 4.277 (0.004 **) | 0.677 6.689 (<0.000 **) | 0.849 2.497 (0.053) | 0.693 6.204 (<0.000 **) | |
Tests of Between-Subjects Effects F (1, 59) (p-value) | ||||
Reflective skepticism | 9.665 (0.003 **) | 0.018 (0.895) | 0.000 (0.988) | 0.064 (0.801) |
Self-examination | 0.000 (0.990) | 16.238 (<0.000 **) | 0.153 (0.697) | 0.103 (0.749) |
Empathetic reflection | 0.034 (0.854) | 2.005 (0.162) | 3.907 (0.053) | 0.403 (0.528) |
Critical open-mindedness | 0.155 (0.695) | 1.210 (0.276) | 0.238 (0.628) | 22.891 (<0.000 **) |
Posttest | Group | Adjusted Mean | (SD) | p-Value |
---|---|---|---|---|
Reflective skepticism | Experimental Control | 46.35 42.51 | (1.08) (1.10) | 0.016 * |
Self-examination | Experimental Control | 46.64 44.68 | (0.87) (0.88) | 0.121 |
Empathetic reflection | Experimental Control | 40.79 37.94 | (0.82) (0.83) | 0.019 * |
Critical open-mindedness | Experimental Control | 40.51 36.71 | (0.96) (0.98) | 0.008 ** |
Test | Covariance | |||
---|---|---|---|---|
Posttest | Perception of trust and receptivity (pretest) | Patient-centered information giving (pretest) | Rapport building (pretest) | Facilitation of patient involvement (pretest) |
Wilk’s Λ F (4, 56) (p-value) | ||||
0.583 10.019 (<0.000 **) | 0.700 5.990 (<0.000 **) | 0.344 26.708 (<0.000 **) | 0.620 8.580 (<0.000 **) | |
Tests of Between-Subjects Effects F (1, 59) (p-value) | ||||
Perception of trust and receptivity | 17.794 (<0.000 **) | 0.973 (0.328) | 5.601 (0.021 *) | 1.107 (0.297) |
Patient-centered information giving | 2.002 (0.968) | 7.846 (0.007 **) | 0.802 (0.374) | 0.284 (0.596) |
Rapport building | 0.368 (0.547) | 0.464 (0.499) | 78.664 (<0.000 **) | 4.989 (0.029 *) |
Facilitation of patient involvement | 2.487 (0.488) | 3.798 (0.056) | 0.802 (0.374) | 6.584 (0.013) |
Posttest | Group | Adjusted Mean | (SD) | p-Value |
---|---|---|---|---|
Perception of trust and receptivity | Experimental Control | 58.96 55.35 | (0.75) (0.76) | 0.001 ** |
Patient-centered information giving | Experimental Control | 52.34 48.06 | (0.58) (0.58) | <0.000 ** |
Rapport building | Experimental Control | 59.14 54.04 | (0.70) (0.71) | <0.000 ** |
Facilitation of patient involvement | Experimental Control | 51.71 46.80 | (0.57) (0.58) | <0.000 ** |
Test | Covariance | ||
---|---|---|---|
Posttest | Behavioral empathy (pretest) | Affective empathy (pretest) | Intellectual empathy (pretest) |
Wilk’s Λ F (3, 58) (p-value) | |||
0.906 2.006 (0.123) | 0.924 1.582 (0.203) | 0.816 4.366 (0.008 **) | |
Tests of Between-Subjects Effects F (1, 60) (p-value) | |||
Behavioral empathy | 3.888 (0.053) | 0.184 (0.669) | 0.627 (0.432) |
Affective empathy | 2.135 (0.149) | 3.451 (0.068) | 4.559 (0.037 *) |
Intellectual empathy | 2.228 (0. 141) | 1.920 (0.171) | 10.334 (0.002 **) |
Posttest | Group | Adjusted Mean | (SD) | p-Value |
---|---|---|---|---|
Behavioral empathy | Experimental Control | 74.14 68.49 | (1.12) (1.14) | 0.001 ** |
Affective empathy | Experimental Control | 51.91 44.74 | (1.37) (1.39) | 0.001 ** |
Intellectual empathy | Experimental Control | 54.26 52.44 | (0.67) (0.68) | 0.063 |
Test | Covariance | ||||
---|---|---|---|---|---|
Posttest | Attention → Representation → affiliation (pretest) | Depth of reflection (pretest) | Focus & context structure (pretest) | Ideas & elaboration (pretest) | Language & conventions (pretest) |
Wilk’s Λ F (5, 54) (p-value) | |||||
0.812 2.503 (0.041 *) | 0.901 1.190 (0.326) | 0.843 2.011 (0.092) | 0.954 0.520 (0.760) | 0.953 0.531 (0.752) | |
Tests of Between-Subjects Effects F (1, 58) (p-value) | |||||
Attention → representation → affiliation | 2.424 (0.125) | 4.255 (0.044 *) | 4.088 (0.048 *) | 1.661 (0.203) | 0.134 (0.715) |
Depth of reflection | 1.931 (0.170) | 0.003 (0.960) | 1.266 (0.265) | 0.494 (0.485) | 0.291 (0.592) |
Focus & context structure | 6.266 (0.015 *) | 1.083 (0.302) | 0.114 (0.737) | 0.067 (0.797) | 2.479 (0.121) |
Ideas & elaboration | 0.354 (0.554) | 0.029 (0.866) | 0.554 (0.460) | 0.058 (0.810) | 0.004 (0.949) |
Language & conventions | 0.000 (0.999) | 1.598 (0.211) | 2.046 (0.158) | 1.027 (0.315) | 0.006 (0.938) |
Posttest | Group | Mean | (SD) | p-Value |
---|---|---|---|---|
Attention → representation → affiliation | Experimental Control | 4.33 2.94 | (0.11) (0.11) | <0.000 ** |
Depth of reflection | Experimental Control | 4.04 3.21 | (0.10) (0.10) | <0.000 ** |
Focus & context structure | Experimental Control | 4.52 4.18 | (0.09) (0.09) | 0.012 * |
Ideas & elaboration | Experimental Control | 4.08 3.76 | (0.10) (0.11) | 0.041 * |
Language & conventions | Experimental Control | 4.09 3.88 | (0.09) (0.09) | 0.094 |
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Share and Cite
Liao, H.-C.; Wang, Y.-h. Storytelling in Medical Education: Narrative Medicine as a Resource for Interdisciplinary Collaboration. Int. J. Environ. Res. Public Health 2020, 17, 1135. https://doi.org/10.3390/ijerph17041135
Liao H-C, Wang Y-h. Storytelling in Medical Education: Narrative Medicine as a Resource for Interdisciplinary Collaboration. International Journal of Environmental Research and Public Health. 2020; 17(4):1135. https://doi.org/10.3390/ijerph17041135
Chicago/Turabian StyleLiao, Hung-Chang, and Ya-huei Wang. 2020. "Storytelling in Medical Education: Narrative Medicine as a Resource for Interdisciplinary Collaboration" International Journal of Environmental Research and Public Health 17, no. 4: 1135. https://doi.org/10.3390/ijerph17041135