Digital Narrative Medicine » Narrative Medicine

Narrative Medicine: theory, clinical practice and education – a scoping review

Giulia Panella — Fri, 18 Apr 2025 09:43:00 +0000

An important article entitled “Narrative Medicine: theory, clinical practice and education – a scoping review” by Ilaria Palla, Giuseppe Turchetti and Stefania Polvani, who for years was president of SIMeN (Società Italiana di Medicina Narrativa), has recently been published in the BMC Health Services Research magazine.

The authors have mapped and analyzed all published studies related to theory, clinical practice and education in Narrative Medicine.

The paper, through a focus on Italy and the United States, or the countries in which MN is most developed, reveals the possibility of future projects in which to measure Narrative Medicine according to an approach that integrates training and clinical practice.

Link to open access article: https://pubmed.ncbi.nlm.nih.gov/39334149/

‘Pushed into humanity’: can learning about storytelling make better doctors?

Emanuela Valente — Thu, 15 Jun 2023 07:59:06 +0000

Narrative medicine encourages doctors to engage more deeply with patients by listening to their stories
The Melbourne general practitioner Mariam Tokhi knows exactly what her friend and colleague the senior paediatric emergency physician Fiona Reilly means when she speaks of her “back pocket full of ghosts”.
Reilly is talking about those haunting memories all medical doctors harbour about their interactions with patients who are sometimes labelled “difficult” or for whom things didn’t go as they should or could have. Some survived, perhaps even flourished. Others died.
Doctors tend to evade their ghosts due to their onerous memorial weight, the expectation of stoicism freighted upon them amid the inhumane demands of the medical profession. But Reilly and Tokhi have a different strategy.
They write about these patients, and their shared experiences with them, as practitioners and now teachers in the University of Melbourne course on narrative medicine. Narrative medicine is a practice new to Australia whereby doctors are encouraged, through writing, to ethically engage far more deeply with their patients’ stories.
At its core, narrative medicine aims to build greater doctor-patient empathy. By listening to and observing patients more acutely, physicians get to understand how story – experience – impacts patients diagnostically and therapeutically. Not least, narrative medicine also nurtures doctors’ creative lives, all too often suppressed by their profession’s punishing demands and overwhelming traditional emphasis on biomedicine and checklists.

Narrative Medicine Writing Saved My Sanity

Emanuela Valente — Wed, 10 May 2023 07:00:11 +0000

Storytelling saved my sanity during the coronavirus pandemic. The lockdown afforded me time to write and share stories about my life and career. I wasn’t writing my memoir as much as I was engaged in the practice of narrative medicine writing — stories about the meaning of illness and opportunities to reflect on the vastness and depth of human experience in the healthcare setting. After I began telling my stories, I discovered the field of narrative medicine has been around since the turn of the century.

Rita Charon, MD, PhD, is widely credited for originating the field of narrative medicine. She inaugurated and teaches in the Master of Science in Narrative Medicine graduate program at Columbia University, where she received her PhD degree in English following her medical degree from Harvard. Charon is also co-author of Principles and Practice of Narrative Medicine and other scholarly works. In her seminal article on narrative medicine, published in the Journal of the American Medical Associationopens in a new tab or window in 2001, Charon wrote: “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.”

Tell Your Patient Story: Michael Vitez video interview

Emanuela Valente — Thu, 02 Mar 2023 03:35:38 +0000

Being a patient makes you the lead character in your health journey. If you have a rare or serious condition, your story might have started decades ago or maybe you’re coping with a brand-new diagnosis. Either way, you have something to say about your lived experience. That’s why we asked Pulitzer-Prize winning journalist Michael Vitez to record this short video that walks you through a seven-minute writing exercise. It’s a no-pressure way to see what happens when you put pen to paper or your fingers to the keyboard.

As a journalist, Vitez spent a lot of time at the bedside, writing about people who were seriously ill. He then went on to create the Narrative Medicine program at the Lewis Katz School of Medicine at Temple University in Philadelphia. Today, he helps doctors in training appreciate the human side of medicine and celebrate stories as an essential element in the doctor-patient relationship.

Watch the video

Narrative medicine, narrative practice, and the creation of meaning

Emanuela Valente — Thu, 09 Feb 2023 07:56:25 +0000

Medical interest in the study of narratives, whether those of patients or doctors, goes back a long way. However, the field of narrative medicine emerged in the late 20th century and is associated in many people’s minds with two seminal texts. One was Narrative Based Medicine: Dialogue and Discourse in Clinical Practice, a collection of essays edited by two British academic general practitioners, Trisha Greenhalgh and Brian Hurwitz. The other was Narrative Medicine: Honoring the Stories of Illness by the US physician and literary scholar Rita Charon. In the years since then, the field has diversified considerably, but there is a consensus among its teachers and practitioners that narrative is central to medicine, requiring attunement to narratives told by patients and clinicians and competence in engaging with them.

Keep reading

Narrative Medicine: A Digital Diary in the Management of Bone and Soft Tissue Sarcoma Patients. Preliminary Results of a Multidisciplinary Pilot Study

Emanuela Valente — Fri, 18 Feb 2022 08:26:02 +0000

Guidelines for the implementation of narrative medicine in clinical practice exist; however, in Italy, no standard methodology is currently available for the management of oncological patients. Since 2017, at the “Regina Elena” National Cancer Institute, studies using “digital narrative diaries” (DNMLAB platform) have been carried out; this article focuses on a pilot, uncontrolled, real-life study aiming to evaluate the utility of DNM integrated with the care pathway of patients with bone and limb soft tissue sarcomas.

Adult patients completed the diary during treatment or follow-up by writing their narrative guided by a set of narrative prompts. The endpoints were: (a) patients’ opinions about therapeutic alliance, awareness, and coping ability; (b) healthcare professionals’ (HCPs’) opinions about communication, therapeutic alliance, and information collection. Open- and closed-ended questions (Likert score: 1-5) were used to assess the items. The preliminary results supported the need to integrate patients’ narratives with clinical data and encourage further research.

Narrative medicine: feasibility of a digital narrative diary application in oncology

Emanuela Valente — Sun, 13 Feb 2022 08:24:41 +0000

A preliminary, open, uncontrolled, real-life study in the oncology and radiotherapy departments of Istituto di Ricovero e Cura a Carattere Scientifico National Cancer Institute Regina Elena, Rome, (Italy), recruiting adult Italian-speaking patients who then completed the DNM diary from the start of treatment, showed that the use of the DNM in oncology patients assisted clinicians with understanding their patients experience. The results published on Journal of International Medical Research

Understanding the causes of a patient’s doubts and fears may help clinicians to provide more detailed explanations, psychological advice, or to be more attentive to scheduling to improve patients’ awareness, empowerment, and treatment adherence. However, for this, appropriate interaction with each patient is needed. If adequately oriented, narrative medicine may help to improve personal relationships, therapeutic alliance, and promote adherence to treatment while fostering the professional growth of clinicians. This approach may provide clinicians with a deeper knowledge of the patient and help them to obtain information that is difficult for patients to communicate during chemo- or radiotherapy sessions and follow-up visits.

Approximately 30 years ago, narrative medicine was first described as a new approach to improving the patient–clinician relationship. Kleinman introduced the use of narratives as a tool to collect and interpret information on the patient’s experience of illness, not only to enrich knowledge about their physical and psychological condition but also to formulate a correct diagnosis. Narratives may have therapeutic potential and may be applied in a way that provides health care professionals with information that can be used for diagnosis or the personalization of treatment. Although the Italian Istituto Superiore di Sanità published recommendations in 2014 for the implementation of narrative medicine in the management of rare and chronic degenerative diseases, no standard method is currently available in Italy for the management of oncology patients.

A specific digital platform has been developed to obtain guided narratives from patients during chemotherapy or radiotherapy for solid tumors. The tool was designed to obtain information about barriers to treatment adherence and to facilitate the relationship between health care professionals and patients. Herein, we report a preliminary study aimed to evaluate the feasibility, practicability, and self-assessed utility of the digital narrative medicine approach from the perspective of both patients and health care professionals.