A Value-Added Health Systems Science Intervention Based on My Life, My Story for Patients Living with HIV and Medical Students: Translating Narrative Medicine from Classroom to Clinic.

In 2018-2019, at the Keck School of Medicine of the University of Southern California (KSOM), we developed and piloted a narrative-based health systems science intervention for patients living with HIV and medical students in which medical students co-wrote patients' life narratives for inclusion in the electronic health record. The pilot study aimed to assess the acceptability of the "life narrative protocol" (LNP) from multiple stakeholder positions and characterize participants' experiences of the clinical and pedagogical implications of the LNP. Students were recruited from KSOM. Patients and staff were recruited from the Maternal, Child, and Adolescent/Adult Center for Infectious Disease and Virology (MCA) at Los Angeles County+USC Medical Center. Ten patients, seventeen students, and ten MCA staff participated in the pilot study. Qualitative methods were used to gather data from students', patients', and staff's perspectives. Three themes emerged from the thematic analysis: (1) patients' life narratives conveyed their unique life experiences and voices; (2) the protocol could result in wide-ranging effects on HIV care; (3) the LNP enabled students to contribute value to patients' healthcare. Across groups, participants considered the LNP an acceptable intervention. The LNP, its limitations, and implications for HIV care, narrative medicine, and health information technology are presented.

Patient Co-Participation in Narrative Medicine Curricula as a Means of Engaging Patients as Partners in Healthcare: A Pilot Study Involving Medical Students and Patients Living with HIV.

This paper describes a pilot study of a new model for narrative medicine training, "community-based participatory narrative medicine" (CBPNM), which centers on shared narrative work between healthcare trainees and patients. Nine medical students and eight patients participated in one of two, five-week-long pilot workshop series. A case study of participants' experiences of the workshop series identified three major themes: (1) the reciprocal and collaborative nature of participants' relationships; (2) the interplay between self-reflection and receiving feedback from others; and (3) the clinical and pedagogical implications of the CBPNM model. Principles and proposed outcomes of the CBPNM model are presented.

Visualizing context through theory deconstruction: a content analysis of three bodies of evaluation theory literature.

While the evaluation field collectively agrees that contextual factors bear on evaluation practice and related scholarly endeavors, the discipline does not yet have an explicit framework for understanding evaluation context. To address this gap in the knowledge base, this paper explores the ways in which evaluation context has been addressed in the practical-participatory, values-engaged, and emergent realist evaluation literatures. Five primary dimensions that constitute evaluation context were identified for this purpose: (1) stakeholder; (2) program; (3) organization; (4) historical/political; and (5) evaluator. Journal articles, book chapters, and conference papers rooted in the selected evaluation approaches were compared along these dimensions in order to explore points of convergence and divergence in the theories. Study results suggest that the selected prescriptive theories most clearly explicate stakeholder and evaluator contexts. Programmatic, organizational, and historical/political contexts, on the other hand, require further clarification.