The Instructional Design and Efficacy of a Narrative Medicine Course for Undergraduate Premedical Students Open Access
Wen, Vivian (Spring 2024)
Abstract
Increased attention toward the social determinants of health and health disparities in the medical field has fueled a movement for person-centered care. The person-centered model of clinical practice relies on narrative competence, or the ability to interpret others’ stories, experiences, values, and desires. There is a relative paucity of English and humanities courses compared to science courses in the current premedical curriculum, which leaves students ill-prepared to interpret patients’ experiences in a clinical setting.
This thesis details why courses that develop compassion and narrative competence via discussion, expressive, and creative writing should be included in the undergraduate premedical curriculum to create more humanistic doctor-patient relationships. A narrative medicine course, IDS 290: Narrative Medicine, was designed and taught at Emory University in the Fall 2023 semester to bridge the divide between the STEM-centered premedical curriculum and the competencies required for person-focused care. The Interpersonal Reactivity Index (IRI), qualitative analysis of student writing, and a course evaluation were used to assess the efficacy of the course.
Fourteen undergraduate students at Emory University who identified as pre-health students took the course and showed improved perspective-taking in their IRI scores and written responses after taking the course compared to before taking the course. Students also exhibited a shift in their perspectives regarding the doctor-patient relationship through written responses that described the humanistic aspects, collaborative, and dynamic nature of the relationship. Students also reported having a clearer understanding of why narratives are important in medicine and how they could apply narrative skills in a clinical setting. Adopting a more interdisciplinary approach to include courses that develop compassion and narrative skills in the undergraduate premedical curriculum can develop perspective-taking skills, broaden students’ understanding of medicine, and work towards more individualized and equitable care for all.
Table of Contents
INTRODUCTION
CHAPTER ONE: THE EVIDENCE BASIS FOR A NARRATIVE MEDICINE COURSE FOR UNDERGRADUATE PREMEDICAL STUDENTS
The History of Medical and Premedical Education
The Nature of Knowledge in Medicine and Science
Narrative Medicine and Narrative Competence
CHAPTER TWO: THE INSTRUCTIONAL DESIGN OF IDS 290: NARRATIVE MEDICINE
The IDS 290: Narrative Medicine Curriculum
Compassion and Social, Ethical, and Emotional Learning
Seminar Courses
Personal Statements
Journaling
Story Circles
Visiting Physicians
CHAPTER THREE: EVALUATING THE EFFICACY OF IDS 290: NARRATIVE MEDICINE
Aims
Institutional Review Board Approval
Study Design
Participants and Demographics
Quantitative Analysis: Interpersonal Reactivity Index
Qualitative Analysis of Student Writing Samples
Student Course Evaluations
Education History Results
Likert Scale Results
Free-Response Results
Discussion
CONCLUSION
About this Honors Thesis
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