Development of a narrative medicine curriculum for pediatric hematology/oncology fellows
2020
Background and Aims: Narrative medicine is a practice that uses patient and provider stories as a mechanism to facilitate written and verbal reflection Narrative medicine curricula have become commonplace in undergraduate medical education;implementation has been slower in post-graduate medical education We aimed to develop and implement a narrative medicine curriculum for pediatric hematology/ oncology fellows and solicit feedback for ongoing improvement Methods: We implemented four one-hour sessions into the pediatric hematology/oncology education curriculum at the Children's Hospital of Philadelphia Attendance was restricted to fellows and facilitators Sessions were facilitated by a faculty member, senior fellow, or chaplain, all with previous experience in narrative medicine All sessions were observed by a research assistant who took detailed field notes Fellows completed pre- and post-session surveys Four sequential sessions were planned: 1) reading and discussion of a non-fiction physician reflection, 2) reading and discussion of a fiction short story, 3) reading and discussion of a poemfollowed bywriting, and 4) writing in response to a prompt Results: We completed 3 narrative medicine sessions Two sessions were completed in person Due to the COVID-19 pandemic, one session was deferred and one session was completed virtually Feedback about sessions was positive (N=6) Participants unanimously endorsed that sessions were helpful to their personal and professional development Comments included: sessions were helpful to process the prior trauma of patient care and good discussion of how to be sensitive to the patient experience Analysis of detailed field notes revealed several themes focusing on the patient experience, coping with patient death, developing an identity as an oncologist and the impact of words and language on interactions with patients Conclusions: A narrative medicine curriculum specific to pediatric hematology/oncology was awelcome addition to the academic curriculum at a pediatric oncology center Future directions include more frequent sessions, incorporating faculty members in to sessions and developing sessions for residents
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