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Sounding Narrative Medicine: Studying Students’ Professional Identity Development at Columbia University College of Physicians and Surgeons

Miller, Eliza MD; Balmer, Dorene PhD; Hermann, Nellie; Graham, Gillian; Charon, Rita MD, PhD

doi: 10.1097/ACM.0000000000000098
Research Reports

Purpose To learn what medical students derive from training in humanities, social sciences, and the arts in a narrative medicine curriculum and to explore narrative medicine’s framework as it relates to students’ professional development.

Method On completion of required intensive, half-semester narrative medicine seminars in 2010, 130 second-year medical students at Columbia University College of Physicians and Surgeons participated in focus group discussions of their experiences. Focus group transcriptions were submitted to close iterative reading by a team who performed a grounded-theory-guided content analysis, generating a list of codes into which statements were sorted to develop overarching themes. Provisional interpretations emerged from the close and repeated readings, suggesting a fresh conceptual understanding of how and through what avenues such education achieves its goals in clinical training.

Results Students’ comments articulated the known features of narrative medicine—attention, representation, and affiliation—and endorsed all three as being valuable to professional identity development. They spoke of the salience of their work in narrative medicine to medicine and medical education and its dividends of critical thinking, reflection, and pleasure. Critiques constituted a small percentage of the statements in each category.

Conclusions Students report that narrative medicine seminars support complex interior, interpersonal, perceptual, and expressive capacities. Students’ lived experiences confirm some expectations of narrative medicine curricular planners while exposing fresh effects of such work to view.

Dr. Miller is a resident, Department of Neurology, Columbia University Medical Center, New York, New York.

Dr. Balmer is associate professor, Department of Pediatrics, and associate director, Center for Research, Innovation and Scholarship in Medical Education, Baylor College of Medicine, Houston, Texas.

Ms. Hermann is creative director, Program in Narrative Medicine, Columbia University College of Physicians and Surgeons, New York, New York.

Ms. Graham is a student, Yale School of Nursing, New Haven, Connecticut.

Dr. Charon is professor of clinical medicine and executive director of the Program in Narrative Medicine, Columbia University College of Physicians and Surgeons, New York, New York.

Funding/Support: Funding for this study came in part from NIH grant 5K07HL082628. Additional support was provided by the Steve Miller Fellowship in Medical Education sponsored by the Department of Pediatrics at the Columbia University College of Physicians and Surgeons.

Other disclosures: None reported.

Ethical approval: Approval for this study was requested from the institutional review board of the Columbia University College of Physicians and Surgeons, and exemption status was received (IRB AAAF3159).

Correspondence should be addressed to Dr. Miller, Department of Neurology, Neurological Institute, 14th Floor, 710 W. 168th St., New York, NY 10032; telephone: (212) 305-1326; e-mail: ecm2137@columbia.edu.

© 2014 by the Association of American Medical Colleges