IMPLEMENTATION OF A NARRATIVE MEDICINE CURRICULUM FOR INTERNAL MEDICINE RESIDENTS

ABSTRACT

SETTING AND PARTICIPANTS: The initial narrative medicine sessions were held virtually over Zoom during the 2020-2021 academic year due to COVID-19. Sessions were held in person during the 2021-2022 academic year. Each session included 8-16 internal medicine residents. Residents participated in a single session during their ambulatory block. DESCRIPTION Narrative medicine has been integrated into medical training with increased depth and frequency to enhance competencies such as observation, reflection, and self-care among trainees. The narrative medicine sessions in this pilot curriculum consisted of one-hour interactive workshops. The workshops began with a brief introduction to the field of narrative medicine, followed by a discussion of a short literary text. After reading and discussing the text, participants were asked to complete a brief writing exercise designed to elicit a personal narrative, and responses were then shared with the larger group. EVALUATION Following the workshop, participants (N=100) completed a retrospective pre- and post- survey assessing the impacts of this intervention on several different variables. Descriptive statistics were used to evaluate pre- and post-workshop differences. Participants also completed open-ended questions assessing what they learned from the session and what they could apply to their future practice, and key themes were extracted. The survey was administered through a HIPAA-compliant online platform, and no personally identifiable data were collected. Participants' interest in learning about the field of narrative medicine increased significantly after the workshop compared to prior (p<0.01). After the workshop, participants noted significantly higher levels of confidence in their ability to listen to patient stories, analyze short pieces of literature, and engage in reflective writing (p<0.01). They also expressed significantly greater agreement with the notions that engaging in literary analysis and reflective writing could improve patient care, reduce provider burnout, and improve connectedness to one's colleagues (p<0.01). Analysis of open-ended questions demonstrated that participants found the sessions to be engaging and worthwhile, and that many skills could be applied to their future practice. DISCUSSION / REFLECTION / LESSONS LEARNED The results of this pilot study suggest that incorporating a brief narrative medicine curriculum into an internal medicine residency program is both feasible and valuable. A single, one-hour session was easily integrated into a pre-existing ambulatory block;participation fostered meaningful reflection, development of observational skills, and connection with colleagues. The session was positively received, and participants were able to appreciate the ways in which narrative medicine could enhance their own medical practice. Future directions include expanding the curriculum over all 3 years of residency and integrating it into existing curricula that address issues such as Social Determinants of Health and Equality, Diversity, and Inclusion.