Using Storytelling & Narrative to Develop Empathy In Medical Students

What is occurring during medical training across the country that would make students feel increasingly less empathy for the patients they will soon care for? A recent study out of Boston University by DC Chen et al, Characterizing changes in student empathy throughout medical school, added to the growing body of knowledge showing a decrease in medical student empathy over the course of their training. Helen Riess MD posted a piece on the October Massachusetts Medical Society’s Vital Signs blog, Teaching Empathy Can Improve Patient Satisfaction, referencing the decline in student empathy over time, but also a Mayo Clinic study that reported 60% of practicing physicians show signs of burnout. If it’s true that so many physicians are this disenchanted with the practice of medicine, is it any wonder that providers need to be reminded to put patients at the center of care?

As medical educators, helping students develop empathy versus lose it over time, can have a positive effect on both patient satisfaction and outcomes. According to M Hojat et al in Academic Medicine in March of 2011, patients working with physicians reporting high empathy scores were significantly more likely to have good control of hemoglobin A1c (56%) & LDL-C (59%) vs those working with physicians reporting low empathy scores (40%, 44%) p<.001. The level of physician empathy was also found to have a “unique contribution” in predicting patient outcomes.

So how then, do you develop and reinforce empathy in your students? Today, many industries are turning to various forms of storytelling to connect the head with the heart, personalizing cold hard facts in a way that evokes emotion and elicits connections to the self and others–something data often fails to accomplish. Many medical educators are catching on to this trend, and programs in Narrative Medicine are growing across the country. Rita Charon MD, PhD, who developed and leads the Program in Narrative Medicine at Columbia University, defines the program’s mission below:

Narrative Medicine fortifies clinical practice with the narrative competence to recognize, absorb, metabolize, interpret, and be moved by the stories of illness. Through narrative training, the Program in Narrative Medicine helps doctors, nurses, social workers, and therapists to improve the effectiveness of care by developing the capacity for attention, reflection, representation, and affiliation with patients and colleagues.

Margaret Cary MD teaches an elective in Narrative Medicine at Georgetown University School of Medicine, where students are encouraged to write about their experience of medical school in order to better understand their place within the world of medicine. Cary has teamed up with Patricia Salber MD, creator of the well-respected healthcare blog, The Doctor Weighs In, to showcase her students’ reflections.

The ultimate goal of a writer is to create characters that evoke empathy so that the reader will invest in the character’s plight, and take part in his/her journey. If medical educators can teach students the skills necessary to uncover and invest in their patient’s plight in a similar way, perhaps that investment will make the joint journey through a healthcare encounter take on new meaning–with the patient’s needs at the center of care.

More on developing the skills of a storyteller to follow…

2 Comments on “Using Storytelling & Narrative to Develop Empathy In Medical Students”

  1. Levette Lamb says:

    i completely agree, we need to nurture our Doctors of the future and help them see the person in the patient

    • Tracy Granzyk MS says:

      Thanks for the comment–I agree wholeheartedly. I have worked with some amazing young medical students and residents at the Telluride Patient Safety Student Summer Camp. It is surprising to me that empathy would decrease over training in their peer group, as I can tell how deeply those I have met care about patients. It seems to me that restructuring the educational environment to accentuate their desire to help others, rather than detract from it, seems like a logical place to start.

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