Tuesday 9 December 2008

Patient narratives in medical education.... where are they?

Since my post about students learning from patient narratives in online forums I have been thinking a lot about how much emphasis we place on patient narratives in medical education.

When talking to individual patients we ask students to consider and explore the patient's experience of their illness along with the history of when symptoms developed and how they have responded to treatment. The exercise I blogged about asks students to compare the narratives of one family with that of others in the course and beyond.

But how often are the findings of qualitative research, which is in a sense about bringing together patient narratives, contributing to medical education? For example, there are several qualitative research studies (here and here for example) on heart failure finding that patients want to know more about prognosis from their physicians. But are we teaching students this? Does the Oxford Textbook of Clinical Medicine discuss the experience of being diagnosed with diabetes or heart failure? Well, I can't find it.

Is it time that we stopped seeing patient narratives as an add-on and started moving it to centre-stage in medical education?

4 comments:

  1. Patient narratives are actually centre stage in medical education except that we somehow always seemed to have harbored a blindness in our central field of vision.

    Also because our efforts as medical students to record and understand our patient narratives have never been given due recognition in terms of assessment credits etc.

    Creating online e portfolios with student facilitated patient narratives and sense making (given due online credits)may change all that.

    rakesh

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  2. Rakesh,
    Thank you very much for your comment and insights.
    Why do we need to move to online eportfoliios to give credit to students for recognising patient narratives? Do you have experience of this? I'd like to know more.

    I agree that narratives are always centre stage. I wrote as much in my earlier post. But then I realised that while the orthodoxy of textbooks do not give them that same standing, to students they may remain peripheral.

    ReplyDelete
  3. This is a wonderful blog and dialogue. I completely agree that the patient's voice should be an integral part of medical education and shouldn't be drowned out by the voice of biomedical science or technology. We're trying to do this at the University of Michigan through a required two-year program, the Family Centered Experience. This involves matching first-year students with volunteer families in the community who have serious or chronic conditions and is done through scheduled home visits for discussions of the volunteers' stories. It's a powerful tool to transform perspectives and has had a very positive effect on many students and on the institution. For further information, our website is http://www.med.umich.edu/lrc/fce/index.html

    I applaud your efforts!

    ReplyDelete
  4. This is a wonderful blog and dialogue. I completely agree that the patient's voice should be an integral part of medical education and shouldn't be drowned out by the voice of biomedical science or technology. We're trying to do this at the University of Michigan through a required two-year program, the Family Centered Experience. This involves matching first-year students with volunteer families in the community who have serious or chronic conditions and is done through scheduled home visits for discussions of the volunteers' stories. It's a powerful tool to transform perspectives and has had a very positive effect on many students and on the institution. For further information, our website is http://www.med.umich.edu/lrc/fce/index.html

    I applaud your efforts!

    Arno

    ReplyDelete

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