How does narrative medicine impact medical trainees' learning of professionalism? A qualitative study.

BACKGROUND: Narrative medicine (NM) is an approach involving narrative skills and is regarded as a model for medical humanism and effective medical practice. This study aims to explore how NM impacts medical trainees' learning of professionalism during a clerkship in a Taiwanese clinical setting. METHODS: A qualitative interview study adopting a purposive sampling method was undertaken. Thirty medical trainees participated in this study, including five fifth-year medical students (MSs), ten sixth-year MSs, nine seventh-year MSs, and six postgraduate year (PGY) trainees. Thematic framework analysis was applied, and a modified realist evaluation approach was further used to analyse the interview data. RESULTS: We identified self-exploration, reflection, and awareness of professional identity as mechanisms explaining how NM impacted professionalism learning in our participants. Furthermore, empathy, communication, doctor-patient relationship and understanding patients were identified as the outcomes of the NM intervention for trainees' learning of professionalism. CONCLUSIONS: NM facilitates medical trainees' self-exploration, reflection, and awareness of professional identity, thereby affecting their learning of professionalism in clinical settings. Adopting NM as an educational intervention in undergraduate medical education could play an important role in professionalism learning, as trainees can thereby be supported to gradually develop self-exploration and reflection capabilities and heightened awareness of professional identity reflectively through a narrative process.

Patients' experiences of long-acting injectable antipsychotics: a qualitative study.

BACKGROUND: In this study, we applied a qualitative approach to explore patients' subjective experiences of long-acting injectable antipsychotics (LAIs). METHODS: Patients undergoing psychiatric treatment from the chronic ward or outpatient department of a medical center in northern Taiwan who had experience with LAI treatment were enrolled. Information was obtained through semi-structured in-depth interviews. The interviews were audio-recorded and then translated verbatim, and the data were collected and analyzed concurrently to develop major themes and categories. RESULT: In total, 14 participants (8 female) were interviewed. In a bio-psycho-social model, the participants used LAIs as a method to become "normal," in order to achieve a balance between the "effects" and "side effects" that may influence their daily lives. Their past experiences constructed their concepts about and expectations regarding LAIs, and their relationships with their family members and co-workers also modeled their experiences. CONCLUSION: In our study, we sought to understand the experience of LAI in the daily life context of the patients. We attempted to use a bio-psycho-social model to evaluate the subjective experience of the patients; an improved understanding can help mental health specialists gain a closer insight into patient experience.

Different perceptions of narrative medicine between Western and Chinese medicine students.

BACKGROUND: Western medicine is an evidence-based science, whereas Chinese medicine is more of a healing art. To date, there has been no research that has examined whether students of Western and Chinese medicine differentially engage in, or benefit from, educational activities for narrative medicine. This study fills a gap in current literature with the aim of evaluating and comparing Western and Chinese Medicine students' perceptions of narrative medicine as an approach to learning empathy and professionalism. METHODS: An initial 10-item questionnaire with a 5-point Likert scale was developed to assess fifth-year Western medical (MS) and traditional Chinese medical (TCMS) students' perceptions of a 4-activity narrative medicine program during a 13-week internal medicine clerkship. Exploratory factor analysis was undertaken. RESULTS: The response rate was 88.6% (412/465), including 270 (65.5%) MSs and 142 (34.5%) TCMSs, with a large reliability (Cronbach alpha = 0.934). Three factors were extracted from 9 items: personal attitude, self-development/reflection, and emotional benefit, more favorable in terms of enhancement of self-development/reflection. The perceptions of narrative medicine by scores between the two groups were significantly higher in TCMSs than MSs in all 9-item questionnaire and 3 extracted factors. CONCLUSIONS: Given the different learning cultures of medical education in which these student groups engage, this suggests that undertaking a course in Chinese medicine might enhance one's acceptance to, and benefit from, a medical humanities course. Alternatively, Chinese medicine programmes might attract more humanities-focused students.

Relationship between personality traits and choosing a medical specialty.

BACKGROUND/PURPOSE: The recent imbalance in the labor market structure of medical specialists can cause problems in access to care, and result in lower quality and increased costs of medical care. The labor market structure of medical specialists requires discussion in relation to specialty selection and personality traits. This study examined the relationship between personality traits and specialist selection among medical students. METHODS: This study used the Edwards Personal Preference Schedule and a customized questionnaire. The participants were 358 medical students of the College of Medicine at Chang Gung University. RESULTS: Medical students scored the highest in Intraception and the lowest in Deference. Women scored significantly higher compared to men for Intraception, Succorance, and Change, whereas men scored significantly higher than women for Dominance and Heterosexuality. Medical students who have family or friends who are also physicians scored higher in Affiliation and lower in Deference than other medical students. Medical students who did not participate in extracurricular activities scored higher in Aggression than those who did. Fourth-year medical students scored significantly higher in Succorance than 7(th)-year medical students. A significant difference was found among medical students of different specialties regarding Exhibition, Autonomy, Intraception, Succorance, and Nurturance. Surgery students scored significantly higher in Exhibition than general medicine students. Students who chose a specialty scored higher in Autonomy than general medicine students. General medicine students scored higher in Intraception and Succorance than surgery students. CONCLUSION: The results of this study can be used as a frame of reference in the field of medical education or in the formulation of governmental policies regarding physician human resource management.