The effective practice of medicine requires narrative competence, that is, the ability to acknowledge, absorb, interpret, and act on the stories and plights of others. Medicine practiced with narrative competence, called narrative medicine, is proposed as a model for humane and effective medical practice. Adopting methods such as close reading of literature and reflective writing allows narrative medicine to examine and illuminate 4 of medicine's central narrative situations: physician and patient, physician and self, physician and colleagues, and physicians and society. With narrative competence, physicians can reach and join their patients in illness, recognize their own personal journeys through medicine, acknowledge kinship with and duties toward other health care professionals, and inaugurate consequential discourse with the public about health care. By bridging the divides that separate physicians from patients, themselves, colleagues, and society, narrative medicine offers fresh opportunities for respectful, empathic, and nourishing medical care.

Reflective writing is one established method for teaching medical students empathetic interactions with patients. Most such exercises rely on students' reflecting upon clinical experiences. To effectively elicit, interpret, and translate the patient's story, however, a reflective practitioner must also be self-aware, personally and professionally. Race, gender, and other embodied sources of identity of practitioners and patients have been shown to influence the nature of clinical communication. Yet, although medical practice is dedicated to examining, diagnosing, and treating bodies, the relationship of physicians to their own physicality is vexed. Medical training creates a dichotomy whereby patients are identified by their bodies while physicians' bodies are secondary to physicians' minds. As a result, little opportunity is afforded to physicians to deal with personal illness experiences, be they their own or those of loved ones. This article describes a reflective writing exercise conducted in a second-year medical student humanities seminar. The "personal illness narrative" exercise created a medium for students to elicit, interpret, and translate their personal illness experiences while witnessing their colleagues' stories. Qualitative analysis of students' evaluation comments indicated that the exercise, although emotionally challenging, was well received and highly recommended for other students and residents. The reflective writing exercise may be incorporated into medical curricula aimed at increasing trainees' empathy. Affording students and residents an opportunity to describe and share their illness experiences may counteract the traditional distancing of physicians' minds from their bodies and lead to more empathic and self-aware practice.

Narrative medicine is a clinical practice fortified by complex narrative skills that equip healthcare professionals to recognize, absorb, interpret, and be moved to action by patients’ and colleagues’ stories of illness. Founded in 2000 at Columbia University by the authors of this volume, narrative medicine provides rigorous conceptual frameworks and practical clinical methods to increase the accuracy and scope of clinicians’ knowledge of their patients and to deepen their therapeutic partnerships. This book presents the authors’ views, enriched by collaboration with a worldwide network of colleagues, of the workings of the narrative, relational, and reflexive processes of healthcare. Literary theory, narratology, continental philosophies, aesthetic theory, and cultural studies provide the intellectual foundations of narrative medicine, while primary care practice, patient-centered care, psychoanalysis, and interprofessional practice supply the clinical foundations.The book provides both principles and practices of the central tenets of the discipline—relationality and emotion, the philosophies of embodiment, ethicality, participatory pedagogy, close reading, creativity, and clinical practice. Each Part of this volume explains the conceptual foundations of its subject and demonstrates the pedagogic or clinical methods of putting those principles into action. Narrative medicine has grown since its inception into an international movement including many health professional disciplines, patients, families, and institutions.The overarching goal of narrative medicine is to improve the effectiveness of healthcare. This volume provides the standards of the field’s theory and practice as a guide to all who are now joining in this creative commitment to improve healthcare for all.

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Objective This study sought to explore the perceived influence of narrative medicine training on clinical skill development of fourth-year medical students, focusing on competencies mandated by ACGME and the RCPSC in areas of communication, collaboration, and professionalism. Methods Using grounded-theory, three methods of data collection were used to query twelve medical students participating in a one-month narrative medicine elective regarding the process of training and the influence on clinical skills. Iterative thematic analysis and data triangulation occurred. Results Response rate was 91% (survey), 50% (focus group) and 25% (follow-up). Five major findings emerged. Students perceive that they: develop and improve specific communication skills; enhance their capacity to collaborate, empathize, and be patient-centered; develop personally and professionally through reflection. They report that the pedagogical approach used in narrative training is critical to its dividends but misunderstood and perceived as counter-culture. Conclusion/Practice implications Participating medical students reported that they perceived narrative medicine to be an important, effective, but counter-culture means of enhancing communication, collaboration, and professional development. The authors contend that these skills are integral to medical practice, consistent with core competencies mandated by the ACGME/RCPSC, and difficult to teach. Future research must explore sequelae of training on actual clinical performance.