ABSTRACT
Purpose@#Narrative medicine consists of the expression of medical experiences and the reflection on narratives to foster empathic communication with patients. Reflecting on narratives increases self-awareness and recognition of the feelings of the narrator or the story’s main character, which in turn affects the audience. This study was conducted to examine the impact of a narrative medicine program on the reflective capacity and empathy of medical students. @*Methods@#A quasi-experimental study was performed during the 2018–2019 academic year at Isfahan University of Medical Sciences in Iran involving 135 medical interns in 2 groups (control [n=66] and experimental [n=69]). Interns in the experimental group took part in seven 2-hour reflective practice sessions, while those in the control group underwent no educational intervention. Pre-test and post-test assessments were conducted for both groups using 2 valid and reliable tools for the assessment of reflective capacity and empathy. Mean reflection and empathy scores were compared within groups (between pre- and post-test values) and between groups (using the paired-t test and the t-test; P≤0.05). @*Results@#The mean reflection and empathy scores of the experimental group significantly increased from pre-test to post-test, but those of the control group did not. Moreover, the mean post-test scores were significantly different between the 2 groups (P<0.001). @*Conclusion@#Narrative medicine is an effective teaching method that can improve reflective capacity and empathy, thereby ultimately promoting professionalism as a core competency in medicine. Consideration of learning conditions and interdisciplinary teaching are necessary for implementing a narrative medicine program.
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.
ABSTRACT
Background: The first and most important step in planning for any system is need assessment and with identifying the most important needs, is a basis for setting goals and appropriate context for organizing other elements. This study aimed to evaluate of restorative treatment need in dental services and was done based on community needs.
Materials and Methods: This was a descriptive-cross sectional study and data gathering was done by an objective form that confirmed its validity. Restorative dental services of 1027 visited patients with non-randomized judgment sampling consecutive during three months at summer in 2012 in Isfahan Farhangian dental clinic was noted on forms and entered into statistical software SPSS [version 17] and results reported. Chi-square test was used for data analyzing. Significant level P <0.05 was considered.
Results: Most of the patients were female [65%]. Restoration of posterior teeth, including 78.5% of total services and most patients' needs for restorative services based on number of teeth were amalgam [67.4%] and least was glass ionomer [0.5%]. Amalgam and composite build up restorations had high proportion in restorative services [42%].
Conclusion: Totally women referring to dentist is more than men and more patients have more than one restorative dentistry need. High prevalence of need to build up restoration means that many caries in the population are at high level, it seems that low level of oral hygiene and neglect and lack of access to have visit, are its reasons.