Implementation and Evaluation of a Pilot Narrative Medicine Curriculum for Internal Medicine Residents

Rebecca K Tsevat; Peter Young; Eunice Zhang; Samuel Baugh; Antonio M Pessegueiro

doi:10.7759/cureus.53396

Implementation and Evaluation of a Pilot Narrative Medicine Curriculum for Internal Medicine Residents

Cureus. 2024 Feb 1;16(2):e53396. doi: 10.7759/cureus.53396. eCollection 2024 Feb.

Authors

Rebecca K Tsevat^{1

2

3}, Peter Young¹, Eunice Zhang^{1

4}, Samuel Baugh^{5

6}, Antonio M Pessegueiro¹

Affiliations

¹ Department of Medicine, Division of General Internal Medicine and Health Services Research, University of California, Los Angeles David Geffen School of Medicine, Los Angeles, USA.
² Department of Medicine, Division of Internal Medicine-Pediatrics, University of California, Los Angeles David Geffen School of Medicine, Los Angeles, USA.
³ National Clinician Scholars Program, University of California, Los Angeles, Los Angeles, USA.
⁴ Department of Medicine, West Los Angeles Veterans Affairs Medical Center, Los Angeles, USA.
⁵ Department of Statistics, Penn State University, University Park, USA.
⁶ Department of Statistics, University of California, Los Angeles, Los Angeles, USA.

Abstract

Background Narrative medicine has been integrated into medical training to enhance competencies such as observation, reflection, and self-care. However, few studies have assessed the impact of a single narrative medicine session using a pre- and post-test study design. The authors of this study sought to implement a pilot narrative medicine curriculum into a large internal medicine residency program and to evaluate its feasibility and impact. Methodology The curriculum consisted of a one-hour reading and writing workshop held during ambulatory academic half-days from 2021 to 2022. Resident participants completed a retrospective pre- and post-workshop survey evaluating their interest and confidence in practicing narrative medicine skills, as well as their beliefs about the impacts of narrative medicine on patient care and provider well-being. Descriptive statistics evaluated pre- and post-workshop differences using the Wilcoxon signed-rank test. Subgroup analyses were conducted based on postgraduate year, residency track, and workshop setting. Additionally, participants completed open-ended questions that were analyzed qualitatively. Results Of 218 resident participants, 152 (69.7%) completed the post-session survey. Participants noted significantly higher levels of confidence and interest in listening to patient stories, analyzing literary texts, and engaging in reflective writing after the workshop. They also expressed significantly higher levels of agreement that engaging in literary analysis and reflective writing could improve patient care, reduce provider burnout, and strengthen connectedness with colleagues. Qualitative analysis demonstrated that participants found the sessions to be worthwhile and appreciated how narrative medicine could enhance their medical practice. Conclusions Incorporating a brief narrative medicine curriculum into an internal medicine residency program is both feasible and valuable. A single narrative medicine session was practical and well-received by residents, as it promoted self-reflection, observational skills, and connection with colleagues. Future workshops should be customized for different training levels and residency tracks, and additional studies should evaluate whether the outcomes persist over time.

Keywords: graduate medical education; internal medicine; med-peds; medical humanities; narrative medicine.