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Medicine is a continuously advancing science, characterized by the integration of multiple disciplines, ultimately focusing on the "human" aspect. Over the past half-century, there has been a global surge in efforts to reshape the humanistic spirit of medicine. Narrative medicine, a field that highly integrates medical professionalism with universal humanistic values, has developed rapidly in China from scratch over the past decade or so. This article introduces the development of narrative medicine both domestically and internationally, explains how to correctly understand the connotation of China's narrative medicine system and the significance of practicing narrative medicine. It analyzes current challenges in clinical practice, education and teaching, scientific research, doctor-patient consensus, and social recognition. Furthermore, it proposes directions for effort, namely, in the context of "greater health" and "new medical science", narrative medicine is empowered to help construct a harmonious medical narrative ecosystem, promote high-quality development in pediatrics, contribute to the innovation in medical education and talent training with humanistic strength and wisdom.

Investigation of clinical medicine undergraduates' recognition of narrative medicine.

BACKGROUND: Narrative Medicine (NM), a contemporary medical concept proposed in the 21st century, emphasizes the use of narrative as a literary form in medicine. This study aims to explore the understanding about NM and willingness to learn NM among medical students in our hospital. METHODS: A questionnaire survey was conducted among 130 students at Xiangya Medical College of Central South University. RESULTS: The findings revealed that a small percentage of students (3.1%) were familiar with narrative medicine and its training methods. Knowledge about the treatment skills (77.7%) and core content (55.4%) of narrative medicine was limited among the students. Despite this, a majority (63.1%) expressed a lack of interest in further understanding and learning about narrative medicine. Surprisingly, the survey indicated that students possessed a high level of narrative literacy, even without formal training in narrative medicine. Additionally, over half of the surveyed students (61.5%) believed that narrative medicine could benefit their clinical practice. CONCLUSIONS: This study serves as a preliminary basis for the future development of narrative medicine education in China. It highlights the need to prioritize medical humanities education and provide medical students with more opportunities to access information on narrative medicine. By doing so, we can strive to enhance the visibility and promote the integration of narrative medicine into medical humanities education in China.

Medical students' perceptions of integrating social media into a narrative medicine programme for 5th-year clerkship in Taiwan: a descriptive qualitative study.

BACKGROUND: The growing demands in integrating digital pedagogies in learning (e.g., social media) contribute to disrupting many fields, including the medical humanities education. However, the strengths and barriers behind social media and medical humanities context are blurred and contradictive. We examined the perceptions of integrating social media - Facebook - into a narrative medicine (NM) programme for 5th -year clerkship in Taiwan. METHODS: We used purposive sampling to recruit participants. Sixteen medical students (Female/Male: 7/9) participated in four group interviews. Semi-structured focus group interviews were conducted to explore students' perceptions and experiences of the social media integrated into the NM programme. We analysed the data using a descriptive thematic analysis with a team-based approach. Data were managed and coded using ATLAS.ti version 9.0. RESULTS: We identified six main themes: (1) Positive experiences of social media integration; (2) Negative experiences of social media integration; (3) Barriers on writing and sharing NM stories in social media; (4) Barriers on reading NM stories in social media; (5) Barriers on reacting contents in social media; (6) Suggestions for future improvement. CONCLUSIONS: The study revealed the strengths and barriers from medical students' perceptions, when integrating social media into a NM programme. It is important to match students' experiences, barriers, and perceptions towards learning. Understanding participants' suggestions for future improvement are also crucial. With this knowledge, we might better develop the social media integration systems that achieve our desired outcomes based on the medical humanities education curricula.

Applying narrative medicine to prepare empathetic healthcare providers in undergraduate pharmacy education in Singapore: a mixed methods study.

BACKGROUND: Narrative medicine demonstrated positive impact on empathy in medicine and nursing students. However, this pedagogical approach had not been evaluated in pharmacy education. This study sought to apply and evaluate the narrative medicine approach in extending empathy in Asian undergraduate pharmacy students. METHODS: Narrative medicine was applied through workshops which used narratives of people with different experiences and perspectives. First-year undergraduate pharmacy students who volunteered and attended these workshops formed the intervention group (N = 31) and the remaining first-year cohort formed the control group (N = 112). A sequential explanatory mixed methods approach was adopted in which quantitative methods were first used to measure impact on pharmacy students' empathy using the Jefferson Scale of Empathy- Health Professions Student (JSE-HPS), and qualitative methods (i.e. group interviews) were then used to assess pharmacy students' emotional responses to narratives, and the perspectives of pharmacy students and faculty of this pedagogical approach. RESULTS: There was no difference in JSE-HPS scores between intervention and control groups across baseline (i.e. upon matriculation), pre-intervention, and post-intervention timepoints. Pharmacy students in the intervention group had lower scores in Factor 3 ("Standing in People's Shoes") following the intervention. Five themes, guided by internal and external factors in cognition, emerged from the Group Interviews: (1) incongruence between students' motivation and faculty's perception, (2) learning context, (3) academic context, (4) cognitive system, and (5) affective system. Themes 1, 4 and 5 referred to internal factors such as students' motivation, perceived learnings, and feelings. Themes 2 and 3 referred to external factors including workshop materials, activities, content, and facilitation. CONCLUSION: This study is the first to demonstrate that pharmacy students engaged with the narrative medicine approach as narratives elicited emotional responses, exposed them to diverse perspectives, and deepened their appreciation of the importance of empathy and complexities of understanding patients' perspectives. Scaffolded educational interventions using narratives and real-life patient encounters, alongside longitudinal measurements of empathy, are necessary to bring about meaningful and sustained improvements in empathy.

Narrative medicine interventions for oncology clinicians: a systematic review.

PURPOSE: As narrative medicine interventions are integrated increasingly into medical practice, growing evidence indicates benefits for healthcare professionals. Presently, the prevalence and impact of narrative medicine interventions in the field of oncology remain unknown. This systematic review synthesizes published data on narrative medicine interventions in oncology and reports current knowledge on feasibility, acceptability, and impact on cancer care professionals. METHODS: Following PRISMA guidelines, we searched Ovid Medline, Embase, Scopus, Web of Science, Cochrane, and ClinicalTrials.gov databases from inception through February 2024. Eligible articles were published in English and contained original data on feasibility, acceptability, and/or impact of a narrative medicine intervention for oncology professionals. Database searches identified 2614 deduplicated articles, from which 50 articles were identified for full-text assessment and 11 articles met inclusion criteria. Two additional articles were identified through manual review of references. RESULTS: Thirteen articles described 12 unique narrative medicine interventions targeting cancer care professionals. All studies described their respective interventions as feasible, acceptable, and impactful for participants. Interventions involved writing, reading, reflection, and other narrative-based strategies. Standardized validated tools evaluated outcomes including burnout, empathy expression, secondary trauma, quality of humanistic care, and well-being. Participants reported appreciation of opportunities for reflection, perspective sharing, and bearing witness, which they perceived to strengthen wellness and community. CONCLUSION: Narrative medicine interventions are feasible and acceptable and may bolster oncology clinicians' functioning across domains. Multi-site, prospective, randomized studies are needed to investigate the broader impact of narrative medicine interventions and advance the science of narrative medicine in oncology. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: CRD42022369432.

Veni, Vidi, Scribivi: I Came, I Saw, I Wrote

Narrative medicine talks at the American Academy of Neurology Annual Meeting have included writing prompts to inspire and promote wellness among attendees. The 6-word writing exercise at the 2023 Annual Meeting prompted pithy and powerful stories, which we share in this article.

Bearing Witness to Joy and Sorrow: Narrative Medicine and Reproductive Endocrinologist and Infertility (REI) Providers' Journeys in Infertility Treatment.

This study examines providers' perceptions of provider-patient communication in reproductive endocrinology and infertility (REI) practices. Grounded in narrative medicine, we interviewed six REI providers about their experiences providing fertility care. REI providers crafted a narrative of bearing witness by (1) situating personal and professional self in REI narratives, (2) sharing news as important medical moments, and (3) cultivating affiliation between provider and patient. These findings offer insight into the power of narrative medicine in fertility care, the role of emplotment in narrative sense-making, and the emotional labor associated with information delivery in REI treatments. We offer several recommendations for how patients and providers can improve communication experiences in REI.

Disability and narrative medicine: Challenges and opportunities.

Despite decades of international entreaties for improvement, education about and provision of healthcare for people with disabilities remains harmfully inferior to that of the non-disabled population. Many obstacles confound efforts to ameliorate this inequity, perhaps the most pernicious of which is negative bias on the part of providers. Narrative medicine offers a means to address healthcare attitudes towards people with disabilities, in particular negative attitudes based on 'ableism'. Through absorbing, writing, and sharing of diverse perspectives, narrative medicine kindles imagination and empathy, promoting self-reflection. This approach enriches the students' capacity to absorb what their patients are trying to say, and to appreciate, respect, and hopefully meet the healthcare needs of people with disability. WHAT THIS PAPER ADDS: Narrative medicine is a pedagogical tool to help providers listen and reflect on patients with disabilities.

Narrative Medicine Theory and Practice: the Double Helix Model.

The genesis of the medical humanities as a discrete academic discipline engendered a need for a theoretical framework, a function taken on by the growing narrative medicine movement. More recently, scholars have begun to develop a critical medical humanities, an analytical movement that emphasises the fundamental enmeshment of the sciences and humanities. Building on Helene Scott-Fordsmand's work on reversing the medical humanities, this paper develops an alternative to the current version of narrative medicine. We propose a new interpretive heuristic, the Double Helix Model, and place it in critical dialogue with the Columbia School's close reading based-approach. Through this new conceptual frame, we suggest that critical narrative medicine may empower clinicians to contribute to the reorientation of the roles of the sciences and humanities, benefiting providers, scholars and patients.

Perspectives on Neuromyelitis Optica Spectrum Disorders, the Narrative Medicine contribution to care.

BACKGROUND: This research aimed to investigate the experience of Neuromyelitis Optica Spectrum Disorders (NMOSD) by integrating the perspectives of patients, caregivers and clinicians through narrative-based medicine to provide new insights to improve care relationships. METHODS: The research was conducted in the second half of 2022 and involved six Italian centres treating NMOSD and targeted adult patients, their caregivers and healthcare providers to collect the three points of view of living with or caring for this rare disease, still difficult to treat despite the pharmacological options. Narratives followed a structured outline according to the time: yesterday-today-tomorrow, to capture all disease phases. RESULTS: Twenty-five patients diagnosed with NMOSD, ten caregivers and 13 healthcare providers participated in the research. Patients reported symptoms limiting their daily activities and strongly impacting their social dimension. We noticed improvements across disease duration, whilst the persistence of limitations was recurrent in patients with longer diagnoses. Caregivers' narratives mainly share experiences of their daily life changes, the burden of the caregiving role and the solutions identified, if any. Healthcare providers defined their role as a guide. CONCLUSION: Limitations in activities are prominent in the lives of people with NMOSD, along with fatigue. Family members are the weakest link in the chain and need information and support. Healthcare professionals are attentive to the helping dimension.

Albológica sine die: De vivencias que habitan memorias donde subsiste la figura y la obra de Francisco Herrera-Rodríguez (1957-2023) / Albológica sine die: De experiências que habitam memórias onde vivem a figura e a obra de Francisco Herrera-Rodríguez (1957-2023) / Albológica sine die: Of experiences that inhabit memories where the figure and work of Francisco Herrera-Rodríguez (1957-2023) subsists

The objective of this article is to vividly evoke the shared experiences with Professor and researcher Francisco Herrera-Rodríguez and to explicitly outline the most significant aspects of his contribution to the history of medicine and nursing, based on both historical research and narrative, highlighting his strong commitment and dedication to literary sources. The methodology employed has focused on autobiography, recalling shared moments in academic, artistic, literary, and leisure contexts; that is, the creation of autobiographical life stories focused on the times when various interactions occurred between Francisco Herrera-Rodríguez and the author. The results demonstrate the importance of Francisco Herrera-Rodríguez's contributions to the history of medicine and nursing. Likewise, the great humanistic quality of the mentioned researcher is evident. Conclusions: Francisco Herrera-Rodríguez, through the cultivation of his favorite passions—historical research, literature, drawing, painting, and art in general—emerged as a profound humanist who positively influenced the education of historians in the fields of medicine and nursing.(AU)

El objetivo de este artículo consiste en evocar de forma nítida las vivencias compartidas con el profesor e investigador Francisco Herrera-Rodríguez y explicitar los aspectos más significativos de su aportación a la historia de la medicina y la enfermería basadas tanto en la investigación histórica como en la narrativa resaltando su gran compromiso y dedicación con las fuentes literarias. La metodología empleada se ha centrado en la autobiografía rememorando momentos compartidos en contextos académicos, artísticos, literarios y de puro ocio; es decir en la elaboración de relatos de vida autobiográficos enfocados a los tiempos en los que se han producido interacciones de diversa índole entre Francisco Herrera-Rodríguez y el autor. Los resultados muestran la importancia de las aportaciones de Francisco Herrera-Rodríguez a la historia de la medicina y la historia de la enfermería. Asimismo, queda demostrada la gran calidad humanística del mencionado investigador. Conclusiones: Francisco Herrera-Rodríguez, mediante el cultivo de sus predilectas pasiones: la investigación histórica, la literatura, el dibujo, la pintura y el arte en general; se erigió en un humanista de gran calado que incidió positivamente en la formación de historiadores de la medicina y la enfermería.(AU)

O objetivo deste artigo é evocar de forma nítida as experiências compartilhadas com o professor e pesquisador Francisco Herrera-Rodríguez e explicitar os aspectos mais significativos de sua contribuição para a história da medicina e enfermagem, com base tanto na pesquisa histórica quanto na narrativa, destacando seu grande comprometimento e dedicação às fontes literárias. A metodologia utilizada concentrou-se na autobiografia, recordando momentos compartilhados em contextos acadêmicos, artísticos, literários e de lazer; ou seja, na elaboração de relatos de vida autobiográficos focados nos momentos em que ocorreram interações de diversas naturezas entre Francisco Herrera-Rodríguez e o autor. Os resultados mostram a importância das contribuições de Francisco Herrera-Rodríguez para a história da medicina e enfermagem. Da mesma forma, a grande qualidade humanística do referido pesquisador fica evidente. Conclusões: Francisco Herrera-Rodríguez, por meio do cultivo de suas paixões preferidas - pesquisa histórica, literatura, desenho, pintura e arte em geral - tornou-se um humanista de grande envergadura que teve um impacto positivo na formação de historiadores da medicina e enfermagem.(AU)

Investigating coping and stigma in people living with HIV through narrative medicine in the Italian multicentre non-interventional study DIAMANTE.

Antiretroviral therapy (ART) significantly reduced Human Immunodeficiency Virus (HIV) morbidity and mortality; nevertheless, stigma still characterises the living with this condition. This study explored patients' coping experience by integrating narrative medicine (NM) in a non-interventional clinical trial. From June 2018 to September 2020 the study involved 18 centres across Italy; enrolled patients were both D/C/F/TAF naïve and previously ART-treated. Narratives were collected at enrolment (V1) and last visit (V4) and then independently analysed by three NM specialist researchers through content analysis. One-hundred and fourteen patients completed both V1 and V4 narratives. Supportive relationships with clinicians and undetectable viral load facilitated coping. Conversely, lack of disclosure of HIV-positive status, HIV metaphors, and unwillingness to narrate the life before the diagnosis indicated internalised stigma. This is the first non-interventional study to include narratives as patient reported outcomes (PROs). Improving HIV awareness and reducing the sense of guilt experienced by patients helps to overcome stigma and foster coping.

Narrative medicine in clinical internship teaching practice.

Objective: To explore the effect on empathy skills of integrating narrative medicine instruction into clinical internship undergraduate medical education.Methods: One hundred clinical undergraduate students who were transferred to gynecology and obstetrics in 2016 were selected as subjects and divided into two groups. The control group adopted the traditional practice teaching mode, while the experimental group adopted a narrative medicine integrated with traditional teaching mode. The impact of the narrative medicine course was evaluated using the Davis Empathy Scale, and the students' acceptance of the course was investigated using a self-developed questionnaire.Results: After completion of the rotation, the empathy scores of the experimental group were higher than those of the control group (p < 0.05). Students in the experimental group rated the integration of narrative medicine into the internship class highly, and most students thought that the narrative medicine course was of great benefit with respect to the humanistic quality of medical teaching.Conclusion: The application of narrative medicine teaching in the clinical practice teaching of obstetrics and gynecology promoted students to improve their empathy ability.

"An invitation to think differently": a narrative medicine intervention using books and films to stimulate medical students' reflection and patient-centeredness.

BACKGROUND: Narrative medicine purports to improve medical students' communication skills, self-reflection, empathy and professional development. These interpersonal skills and attitudes can facilitate more patient-centered care and positively impact patients' treatment outcomes. However, current studies report mainly on small study populations, leaving the efficacy of narrative medicine in larger study groups unknown. Therefore, this study aimed to evaluate a mandatory narrative medicine lesson in a large sample of medical students. We assessed if this narrative medicine lesson stimulated meaningful self-reflection on patient-centeredness in medical students. METHODS: All fourth-year medical students of a Dutch medical school participated in this mandatory narrative medicine lesson. The four-step activity consisted of an introductory lecture, close reading and watching of a book and film, a discussion group and a short reflective writing exercise. Students were divided over three thematic pairings (or book and film combinations): 'The doctor as a patient,' 'The mysterious brain,' and 'Until death do us part.' A mixed-methods design was used. First, we qualitatively analyzed the content of 203 essays from the reflective writing exercise. A quantitative analysis of the reflective quality was conducted using a scoring-system based on the REFLECT rubric. RESULTS: Students demonstrated reflection on a professional level and connected this to future intentions as medical practitioners, for example to use specific communication strategies or to deliver healthcare in a broader sense. They also reflected on a personal level by questioning their own worldview or beliefs. Furthermore, they stressed the importance of individual patient stories to gain understaning of patients' perspectives. Approximately half of the students showed an in-depth and authentic reflection, according to the REFLECT rubric. Additionally, reflection levels differed between book and film pairings. CONCLUSIONS: This study supports the value of narrative medicine in the medical curriculum by validating its outcomes in a larger study population and in a mandatory course. Students reflected on themes related to the principles of patient-centeredness, namely personal attitudes towards patients and the uniqueness of patient stories. In additon, the majority of students demonstrated higher levels of reflection, which suggests that this exercise contributes to self-awareness and self-reflection, important qualities for delivering patient-centered healthcare.