Can narrative medicine training improve OSCE performance?

Can narrative medicine education contribute to the delivery of compassionate care? A review of the literature

“…In a similar way, Arntfield et al 26 found that students overwhelmingly reported enhanced communication characterised by empathic skills such as listening and valuing different perspectives or worldviews. Although the qualitative studies gave rich examples of how this was reported by participants in terms of narrative, objective measurements are also demonstrated by Tsai and Ho16 and Misra-Hebert et al 20 in the outcomes of the OSCE and JSE scores, respectively. While empathy was most powerfully demonstrated in those studies that included narrative reflective writing, even the studies with less intense Narrative Medicine education showed a positive impact on empathy and communication, for example, Shapiro et al 19…”

“…The results showed that the case group performed better on the two communication stations (p=0.03), but there was no difference across the 12 stations when taken as a whole (p=0.24). Tsai and Ho16 demonstrated that Narrative Medicine can improve performance in terms of communication and, critically, this is one of the few studies to have demonstrated an objective behavioural outcome. There are, however, significant limitations and questions regarding rigour, not least because the study is relatively brief.…”

“…In a quantitative study, Tsai and Ho16 used a quasi-experimental design to examine whether Narrative Medicine could enhance clinical performance as measured by objective, structured, clinical examination (OSCE). While this design lends itself to the comparison of a randomly selected intervention group with a case-matched control, this study did not employ a pre-intervention OSCE measurement in either group which might have strengthened the approach 17.…”

“…In contrast to Tsai and Ho,16 they measured learning rather than a behavioural outcome in the OSCEs. They used a five-point Likert scale response to one question concerning empathy and another addressing the impact on treatment plans.…”

“…Each study was appraised using tools and guidance designed by the evidence for policy and practice information and coordinating centre14 and the critical appraisal skills programme 15Studies appraised by this review Quantitative study Tsai and Ho16 Combined quantitative and qualitative studies Shapiro et al 19 Misra-Hebert et al 20 Lancaster et al 22 Qualitative studies Clandinin and Cave24 Lazarus and Rosslyn28 Arntfield et al 26 Gull et al 29 DasGupta and Charon27 …”