Medicine and the arts, the role of narrative medicine in medical education

Problem

The topic of ‘medical humanities’ is not a new area of medicine but it is one which is becoming increasingly recognised within the medical school curriculum. Since the 20th century there has been an increased recognition of the human side of medicine and a need to readdress the balance between this and hard sciences within medical schools. Historically, storytelling has been used as a way to enhance understanding of illness and the effect on the person as a whole, Shakespeare’s Hamlet and depressive illness are clear examples of this. More recently the movement of narrative medicine could be said to be a rebirth of this concept. Charon’s work discusses narrative medicine in two forms, that of the doctor as a storyteller or listener and the patient as the storyteller. The benefits of involving narrative medicine and medical humanities in the curriculum are suggested to include improved communication, empathy and possibly a more resilient well rounded doctor. However, there is little published on how medical humanities can be delivered in an already compact medical curriculum or the student experience of such teaching. This teaching evaluation aims to address the role of medical humanities in medical education and its impact on student doctors.

Approach

This is a teaching evaluation of a 10 week module delivered by a GP and trainee GP to two groups of second year medical students. The content included narrative medicine; involving experts by experience from marginalised groups such as those living with disability and medicine in the narrative; the role of literature in portraying and understanding medicine. For practical purposes the teaching evaluation consisted of pre and post questionnaires which were completed by students over two separate cohorts. Questionnaires were designed to produce quantitative data using a Likert scale for empathy and free text feedback for qualitative inductive thematic analysis of comments to better understand the student experience of the module.

Findings

Student reported empathy levels increased following the taught module by 2 points on the Likert scale. Preliminary thematic analysis of feedback comments identified the following themes: communication, empathy, medicine as an art, restorative learning. These themes will be further refined and re-defined in the coming months.

Consequences

The findings imply that narrative medicine and medical humanities have a valuable role in medical student education. This value can be considered from the student perspective; deepening their understanding of medicine in a different context, providing a restorative setting for learning and resilience skills as well improved communication and empathy towards patients, particularly those who are marginalised. Moreover, a structure and format for delivering such education has now been outlined and evaluated.