Initiating Narrative Medicine at a Medical College in Pakistan: Achievements, Challenges, and Opportunities.

Writing has always been a part of medicine, but it was largely used as a means to disseminate objective data. With changing times, qualitative writing in the form of narrative medicine (NM) is fast coming to the forefront. Data in the field from high-income countries have shown an enhancement in empathy and professionalism alike, for both patients and health care practitioners. Studies also elucidate the benefits of incorporating NM into medical curricula. However, there is scant literature from low-income to middle-income countries concerning NM. In this brief report, we discuss NM in the context of low- to middle-income regions like ours, describing how a workshop on NM-based reflective writing was developed and executed at Aga Khan University, Karachi, Pakistan. This workshop, titled "Narrative Medicine: Where Every Patient's Story Matters," was conducted in January 2016 and was attended by medical students, residents, and physicians as well as professionals from nonmedical backgrounds. The workshop served as an introduction to NM, and there are plans to further develop it at Aga Khan University. This development includes creating a digital library of narratives, releasing an annual NM newsletter, incorporating NM into the undergraduate curriculum, and conducting studies to assess the impact of our intervention.

Revisiones panorámicas. Otra forma de revisión de la literatura / Scoping reviews. Another way of literature review

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Narrative medicine as a medical education tool: A systematic review.

Aim: Narrative medicine has been promoted as an innovative and effective means of stimulating medical students' professional development by teaching them to approach their patients' experiences of illness with more understanding and compassion. This systematic literature review aims to answer the following question: what evidence of effect is available in the literature about models for teaching narrative medicine? Methods: We conducted a narrative review of 36 articles and used the Best Evidence in Medical Education (BEME) Global Scale and Kirkpatrick Scale for strength and importance of evidence to categorize reported assessment strategies and to evaluate the effectiveness of their narrative medicine programs. Results: We found evidence that narrative medicine is an effective pedagogic tool with a clear and replicable structure and methodology. We also determined that a positive impact could be measured when pertaining to participation and modification of attitudes, knowledge, and skills. However, unequivocal evidence of the effect of narrative medicine on students' behavior or ongoing interaction with colleagues and patients is still lacking. Conclusion: While many recent publications describe the goals and virtues of a narrative-based approach, more research is needed to determine whether or not there is an ideological consensus undergirding this approach. In addition, it is still unclear whether the long-term impact of narrative medicine classroom interventions are felt by patients, or whether such interventions positively impact patient care.

Implementing a Narrative Medicine Curriculum During the Internship Year: An Internal Medicine Residency Program Experience.

INTRODUCTION: Narrative medicine develops professional and communication skills that align with Accreditation Council for Graduate Medical Education competencies. However, little is known about a narrative medicine curriculum's impact on physicians in training during residency. Implementing a narrative medicine curriculum during residency can be challenging because of time constraints and limited opportunity for nonclinical education. METHODS: Six sessions were implemented throughout one academic year to expose first-year internal medicine residents (interns) to narrative medicine. Attendance and participation were documented. At the end of the year, interns completed an open-ended survey to gauge their perception of their experience with the sessions. RESULTS: In total, 17 interns attended at least 1 narrative medicine session, and each session averaged 5.4 attendees. Thirteen eligible interns completed the survey. Thematic analysis identified 3 predominant themes: Mindfulness, physician well-being, and professionalism. DISCUSSION: Overall, the narrative medicine sessions were well attended and the curriculum was well received. This intervention demonstrates the value of a narrative medicine curriculum during medical resident training. Large prospective studies are necessary to identify the long-term benefits of such a curriculum.