Using narratives to trigger reflection.

BACKGROUND: During the medical course at Dundee students are taught patient-centred medicine, and are encouraged to reflect actively upon their experiences. However, students often have limited familiarity with sensitive and life-changing events; this can make subsequent reflection superficial and of limited value. Many also struggle with the concept of reflection and how it can be used to further their personal and professional development.

CONTEXT: We developed and ran a student-selected component (SSC) that included the study of illness narrative as a way of facilitating reflection and increasing student awareness of the patient perspective of illness.

INNOVATION: Patient and doctor narratives were used as a proxy for patient contact, and allowed the exploration of sensitive topics including mental health issues, death and bereavement in a supportive context. Using a range of narratives we supported students in their reflections on these topics and identified increased self-awareness and a better understanding of the patient perspective. Students also discussed an intention to change their own practice.

IMPLICATIONS: Limited opportunities may exist for students to develop insight into the challenges faced by doctors and patients presented with challenging or sensitive illness and difficult decisions. The use of patient and doctor narratives to facilitate discussion and encourage reflection on sensitive issues can offer a useful supplement to patient contact.