"Rooted in Healing: Residents Crafting a Narrative Medicine Curriculum"
A group of pediatrics residents have taken the lead in designing and implementing a narrative medicine (NM) curriculum to enhance their clinical training and improve their relationships with colleagues and patients. The curriculum, facilitated by a resident with a master's degree in NM, was found to be feasible and effective in promoting self-reflection, inclusivity, and humanistic care.
The study, published in the journal Nature Medicine, highlights the potential of peer-led NM workshops to address the challenges and stress faced by healthcare professionals, particularly during the COVID-19 pandemic. The curriculum was designed to create opportunities for reflection, group cohesion, and development of skills of close listening amongst those engaged in delivering healthcare.
The NM curriculum consisted of seven workshops for residents of all training years, led by residents who were trained in NM facilitation. The workshops followed the methodology developed by the NM Program at Columbia University, with each 1-h workshop consisting of three activities: 30 minutes of close reading or observation of a creative work, 5 minutes of writing to a prompt, and 15 minutes of sharing written responses in dyads and with the whole group. The curriculum was dynamically adapted to suit residents' needs, with works centering on mortality, illness, relationships, medical training, and current events.
The study conducted semi-structured interviews with 15 residents who had attended at least two workshops. The interviews explored how the NM workshops impacted residents' experiences inside and outside the hospital, their relationships with patients, colleagues, and loved ones, as well as the experience of facilitation by co-residents.
The analysis of the interviews revealed three themes: reflection on personal and professional identity, connection to others and community building, and reconceptualization of medical practice. Participants shared that they experienced greater solidarity, professional fulfillment, appreciation for multiple facets of their identities, recognition of holding space for vulnerability, and advocacy for marginalized populations.
The study highlights the importance of peer teaching and support in medical education. Physicians often identify peers as the most acceptable sources of support, and resident wellness benefits from peer-support interventions. Trainees value learning from peers due to their social and cognitive congruence, creating a climate of safety and comfort in which learners can be more vulnerable with each other.
The NM curriculum by residents for residents is a promising application of peer-led education to promote reflection, close listening, and solidarity. The study demonstrates that such a curriculum may be of particular benefit to pediatricians and pediatricians-in-training, who attend to children's stories across the span of development and within the context of their families and communities.
The NM curriculum is a beacon of hope for healthcare professionals seeking to regain fulfillment in their work and address relevant healthcare barriers and biases. The study provides a model for NM to be adapted in a variety of educational and clinical settings that facilitates a culture shift towards a more humanistic and inclusive approach to healthcare.
URL: <https://www.nature.com/articles/s41390-024-03142-2>
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