Type of Submission: Teaching Material

Listening to Patient Narratives Exercise: Anju’s Breast Cancer story

This is an outline for a class exercise utilizing a video from the Look Now Project. The short documentary tells Ajnu’s story of treatment for breast cancer.

The class exercise is part of a one-hour session entitled “Between the Lines,” part of a training by the Northwest Narrative Medicine Collaborative in collaboration with Lewis & Clark College, which brought together undergraduate students, medical students, and medical professionals for a one-day workshop. In the “Between the Lines” session, we examined how clinical interactions are framed by medical scripts and encourage changing these frames to make room for patient stories. Then we engage in practicing listening closely to patient stories for what is said, how it is said, what is not said, and how our own experiences and identities shape what we hear.

Haiku Rules of the Road

The online publication Pulse: Voices from the Heart of Medicine provides this brief set of instructions for writing haiku. The Pulse site also includes many examples of haiku. These instructions (and examples from the site) could be used in a variety of settings. For example, the Northwest Narrative Medicine Collaborative teaches a session on writing haiku as part of it’s narrative scribe training, a workshop dedicated to developing the skills of listening closely to a story, and then offering it back to the teller. Just as medical record keeping often distills a detailed patient narrative into the forms required for diagnosis and health record keeping, so too haiku can be used to distill a narrative into a gist. The contrast between what details might make it into an electronic health record and what details a haiku might focus upon can prompt discussion of what is left out of many clinical interactions.

Writing haiku can also be a useful exercise in college courses. It is an accessible form of poetry to teach as one example and can prompt discussion of what constitutes a narrative.

Reflective MedEd

The “About” section of this blog explains its purpose as follows: “Reflective MedEd is dedicated to reflective practice in medical education and care of the person. We publish contributions that offer insight and illumination into the experience of educating the next generation of physicians. We welcome the thoughts of educators, patients, and all who foster awareness of the human dimension of doctoring and develop advocates for the just and equitable treatment of all patients.” Especially welcome are submissions that address “social justice and a concern for marginalized and vulnerable populations, the role of faith in medical practice, and ethical standards of decision making.” Reflective MedEd is supported by the Ralph P. Leischner, Jr., MD, Department of Medical Education at Loyola University Chicago Stritch School of Medicine.

Blog posts include both personal narratives and reflective essays from a variety of experiences and perspectives. For example: “How COVID Impacted my First Patient and Patient Death Experience,” “What I have Learned About Trust from Black Women,” and “The Wolf: How skeptical should we be of our patients?”

Syllabus Spanish Health Narratives

This 3000-level course is of particular interest to Spanish majors and minors with health professions interests, although readings and assignments are aimed at any Spanish student with intermediate level proficiency. Creative writing majors from English, students interested in editing and publishing, International Studies and Global Health Studies majors, Communication Studies majors with general interests in health, all have succeeded. Readings are from Latinx and Latin American authors; some in English, many in Spanish. Assignments are four creative writing projects, one that becomes a digital video.

Class outline for teaching Parsons’ Sick Role

Outline for a 60 minute lecture/discussion on Talcott Parsons’ concept of “the sick role.” Arguments for the significance of patient voice and narrative (e.g., Arthur Frank’s Wounded Storyteller) often take Parson’s sick role as a point of contrast. Likewise, the practice of narrative medicine by physicians is a rejection of the paternalistic and objective physician that is the counterpart to the “sick patient” in Parson’s analysis.

The outline is from an upper-division undergraduate course on health narratives offered in a department of Rhetoric & Media Studies (the course also enrolls students studying sociology, English, and pre-health). The class outline provides a very brief background to Parsons’ larger project, goes into some detail about the elements of the sick role and the corresponding role of the physician. The session ends with discussion questions about the implications of this concept.

Health Narratives syllabus

This is a syllabus for an undergraduate junior/senior level semester-long course at Lewis & Clark College. The course focuses on how stories of health and illness are a place to explore the rhetoric of identities, relationships, health care, and public policy. For example: How do we use narratives to (re)construct identities altered by illness? How can narratives (re)shape interactions between patients and health care providers? What narratives capture public attention and with what implications for health care decision-making and policy? The course covers theories and research on health narratives and narrative research methods. It serves as an overview to this area of research as well as a training ground for doing your narrative research. The course is an elective for students in the Rhetoric & Media Studies major but also draws students from sociology, English, and pre-health. The course is a 25 person seminar-style course for juniors and seniors.

Fifty-five word stories: “Small jewels” for personal reflection and teaching

Fifty-five word stories are brief pieces of creative writing that use elements of poetry, prose, or both to encapsulate key experiences in health care. In this article, family physician Colleen Fogarty describes how she has used 55-word stories in a seminar she led at the 2009 annual meeting of the Society of Teachers of Family Medicine (STFM). The article includes a table with instructions on how to write a 55-word story, a description of her seminar and tips on how she taught it, and examples of writing and reactions from the faculty in family medicine residency programs who participated in her seminar. The article is available free of charge in PubMed.