Content and outcomes of narrative medicine programmes: a systematic review of the literature through 2019

Objectives Narrative medicine (NM) incorporates stories into health sciences paradigms as fundamental aspects of the human experience. The aim of this systematic review is to answer the research question: how effective is the implementation and evaluation of NM programmes in academic medicine and he...

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Main Authors: Emelia J Benjamin, Christy DiFrances Remein, Ellen Childs, John Carlo Pasco, Ludovic Trinquart, David B Flynn, Sarah L Wingerter, Robina M Bhasin, Lindsay B Demers
Format: Article
Language:English
Published: BMJ Publishing Group 2020-01-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/10/1/e031568.full
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author Emelia J Benjamin
Christy DiFrances Remein
Ellen Childs
John Carlo Pasco
Ludovic Trinquart
David B Flynn
Sarah L Wingerter
Robina M Bhasin
Lindsay B Demers
author_facet Emelia J Benjamin
Christy DiFrances Remein
Ellen Childs
John Carlo Pasco
Ludovic Trinquart
David B Flynn
Sarah L Wingerter
Robina M Bhasin
Lindsay B Demers
author_sort Emelia J Benjamin
collection DOAJ
description Objectives Narrative medicine (NM) incorporates stories into health sciences paradigms as fundamental aspects of the human experience. The aim of this systematic review is to answer the research question: how effective is the implementation and evaluation of NM programmes in academic medicine and health sciences? We documented objectives, content and evaluation outcomes of NM programming to provide recommendations for future narrative-based education.Methods We conducted a systematic review of literature published through 2019 using five major databases: PubMed, Embase, PsycINFO, ERIC and MedEdPORTAL. Eligible NM programming included textual analysis/close reading of published literature and creative/reflective writing. Qualifying participants comprised individuals from academic medicine and health sciences disciplines. We reviewed and categorised programme goals, content and evaluation activities to assess participant satisfaction and programme efficacy. Two members of the research team assessed the risk of bias, independently screening records via a two-round, iterative process to reach consensus on eligibility.Results Of 1569 original citations identified, we selected 55 unique programmes (described in 61 records). In all, 41 (75%) programmes reported a form of evaluation; evaluation methods lacked consistency. Twenty-two programmes used quantitative evaluation (13 well described), and 33 programmes used qualitative evaluation (27 well described). Well-described quantitative evaluations relied on 32 different measures (7 validated) and showed evidence of high participant satisfaction and pre-post improvement in competencies such as relationship-building, empathy, confidence/personal accomplishment, pedagogical skills and clinical skills. An average of 88.3% of participants agreed or strongly agreed that the programme had positive outcomes. Qualitative evaluation identified high participant satisfaction and improvement in competencies such as relationship-building, empathy, perspective-taking/reflection, resilience and burnout detection/mitigation, confidence/personal accomplishment, narrative competence, and ethical inquiry.Conclusion Evaluation suggests that NM programming leads to high participant satisfaction and positive outcomes across various competencies. We suggest best practices and innovative future directions for programme implementation and evaluation.
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spelling doaj-art-a8dec600ec234c9bb175072b64febd792025-08-20T02:36:10ZengBMJ Publishing GroupBMJ Open2044-60552020-01-0110110.1136/bmjopen-2019-031568Content and outcomes of narrative medicine programmes: a systematic review of the literature through 2019Emelia J Benjamin0Christy DiFrances Remein1Ellen Childs2John Carlo Pasco3Ludovic Trinquart4David B Flynn5Sarah L Wingerter6Robina M Bhasin7Lindsay B Demers8Department of Medicine, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USABoston University School of Medicine, Boston, Massachusetts, USABoston University School of Public Health, Boston, Massachusetts, USABoston University School of Medicine, Boston, Massachusetts, USAsenior statisticianAlumni Medical Library, Boston University School of Medicine, Boston, Massachusetts, USABoston University School of Medicine, Boston, Massachusetts, USABoston University School of Medicine, Boston, Massachusetts, USABoston University School of Medicine, Boston, Massachusetts, USAObjectives Narrative medicine (NM) incorporates stories into health sciences paradigms as fundamental aspects of the human experience. The aim of this systematic review is to answer the research question: how effective is the implementation and evaluation of NM programmes in academic medicine and health sciences? We documented objectives, content and evaluation outcomes of NM programming to provide recommendations for future narrative-based education.Methods We conducted a systematic review of literature published through 2019 using five major databases: PubMed, Embase, PsycINFO, ERIC and MedEdPORTAL. Eligible NM programming included textual analysis/close reading of published literature and creative/reflective writing. Qualifying participants comprised individuals from academic medicine and health sciences disciplines. We reviewed and categorised programme goals, content and evaluation activities to assess participant satisfaction and programme efficacy. Two members of the research team assessed the risk of bias, independently screening records via a two-round, iterative process to reach consensus on eligibility.Results Of 1569 original citations identified, we selected 55 unique programmes (described in 61 records). In all, 41 (75%) programmes reported a form of evaluation; evaluation methods lacked consistency. Twenty-two programmes used quantitative evaluation (13 well described), and 33 programmes used qualitative evaluation (27 well described). Well-described quantitative evaluations relied on 32 different measures (7 validated) and showed evidence of high participant satisfaction and pre-post improvement in competencies such as relationship-building, empathy, confidence/personal accomplishment, pedagogical skills and clinical skills. An average of 88.3% of participants agreed or strongly agreed that the programme had positive outcomes. Qualitative evaluation identified high participant satisfaction and improvement in competencies such as relationship-building, empathy, perspective-taking/reflection, resilience and burnout detection/mitigation, confidence/personal accomplishment, narrative competence, and ethical inquiry.Conclusion Evaluation suggests that NM programming leads to high participant satisfaction and positive outcomes across various competencies. We suggest best practices and innovative future directions for programme implementation and evaluation.https://bmjopen.bmj.com/content/10/1/e031568.full
spellingShingle Emelia J Benjamin
Christy DiFrances Remein
Ellen Childs
John Carlo Pasco
Ludovic Trinquart
David B Flynn
Sarah L Wingerter
Robina M Bhasin
Lindsay B Demers
Content and outcomes of narrative medicine programmes: a systematic review of the literature through 2019
BMJ Open
title Content and outcomes of narrative medicine programmes: a systematic review of the literature through 2019
title_full Content and outcomes of narrative medicine programmes: a systematic review of the literature through 2019
title_fullStr Content and outcomes of narrative medicine programmes: a systematic review of the literature through 2019
title_full_unstemmed Content and outcomes of narrative medicine programmes: a systematic review of the literature through 2019
title_short Content and outcomes of narrative medicine programmes: a systematic review of the literature through 2019
title_sort content and outcomes of narrative medicine programmes a systematic review of the literature through 2019
url https://bmjopen.bmj.com/content/10/1/e031568.full
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