Regaining Our Humanity Through Story Sierpina Explore 2007
Regaining Our Humanity Through Story Sierpina Explore 2007
Regaining Our Humanity Through Story Sierpina Explore 2007
In this issue of Innovations in Integra- homes to just get their story, not a medical history.” This means that we coconstruct
tive Healthcare Education, we are de- history, as part of a required course on the with the patient the reality of the medical
parting from our usual format of spot- practice of medicine. Many students find encounter and the tone and timbre of the
lighting specific projects or programs in this immensely anxiety provoking, due to healing relationship. By bringing our own
lieu of presenting a more extended piece the lack of structure and familiar context. culture, beliefs, and values to the exam
by MacKenzie on relationship-centered However, ultimately they find an oppor- room and then allowing the patient to
care and narrative medicine. The impor- tunity to encounter a real person in a non- share theirs with us, we create a new kind
tance of these topics cannot be overesti- clinical setting. A scoring rubric based on of relationship-centered, patient-centered
mated in their role of humanizing the the construction and quality of a short care model. This allows the strength of the
healthcare encounter, improving self- story allows us to grade the students objec- linear standard medical history, chief
awareness of the practitioner, and creat- tively. However, a most interesting find-
complaint, history of present illness, past
ing a space in which the patient feels ing, which we expect to present at the Ot-
history, social/family history, review of
deeply listened to. A commentary by Dr tawa Conference in Australia next spring,
systems, etc, to be informed and enriched
Michelle Sierpina is also included in this is the process of personal transformation
by the nonlinear, perhaps circular, patient
special section to put into context the that such story writing has for students.
story. This story making further allows
power of narrative in medicine and in This is also reported by MacKenzie in her
patients’ lives. Her recent PhD focused article and in Sierpina’s accompanying deeper exploration of the patient’s life
on the power of life stories told by se- commentary. The importance of captur- goals as well as their medical goals.1 It cre-
niors; that research and training enables ing and understanding the patient’s story ates increased personalization of the pro-
her to provide a broad and scholarly re- is also a major focus in nurse practitioner vider-patient relationship and moves from
view of the power of story in relation to programs across the United States, where the “I-them” to Buber’s “I-thou.” Enjoy
MacKenzie’s article. the art of listening and the importance the article and the accompanying com-
In the medical school at University of of patient narratives have long been mentary and consider how to implement
Texas Medical Branch, we send out first- emphasized. this kind of care and mindfulness into the
year medical students in the first couple of In an integrative assessment of patients, education of health professional students
months of the first semester to patients’ we “make a history” rather than “take a and your practice.
s American healthcare experi- mensions. This deepened perspective will structed for the past three centuries or so.
BIBLIOGRAPHY 3. Tresolini CP, Pew-Fetzer Task Force. 10. Novack DH, Suchman AL, Clark W, Ep-
Antonovsky A. Unraveling the Mystery of Health Professions Education and Relation- stein RM, Najberg E, Kaplan C. Calibrat-
Health. San Fransisco, Calif: Jossey-Bass ship-Centered Care. San Francisco, Calif: ing the physician: personal awareness and
Inc; 1987. Pew Health Professions Commission; effective patient care. JAMA. 1997;278:
Fried C, Madar S, Donley C. The Bio- 1994. 502-509.
4. Institute of Medicine. Improving Medical 11. Smith RC, Dorsey AM, Lyles JS, Frankel
medical Humanities Program: merging
Education: Enhancing the Behavioral and So- RM. Teaching self-awareness enhances
humanities and science in a premedical
cial Science Curricula of Medical School Curric- learning about patient-centered interview-
curriculum at Hiram College. Acad Med.
ula. Washington, DC: National Academies ing. Acad Med. 1999;74:1242-1248.
2003;78:993-996. Press; 2004. 12. Shapiro SL, Schwartz GE, Bonner G. Ef-
Yamada S, Maskarinec GG, Greene GA, 5. Hawkins AH, Ballard JO, Hufford DJ. Hu- fects of mindfulness-based stress reduction
Bauman KA. Family narratives, culture, manities education at Pennsylvania State on medical and premedical students. J Be-
and patient-centered medicine. Fam Med. University College of Medicine, Hershey, hav Med. 1998;21:581-599.
2003;35:279-283. Pennsylvania. Acad Med. 2003;78:1001- 13. Meier DE, Back AL, Morrison RS. The
1005. inner life of physicians and care of the
6. Koop CE. seriously ill. JAMA. 2001;286:3007-
REFERENCES 7. Heymann J. Equal Partners: A Physician’s 3014.
1. Waters D, Sierpina V. Goal directed health- Call for a New Spirit of Medicine. Philadel- 14. Milstein JM, Gerstenberger AE, Barton S.
care and the chronic pain patient: a new phia, Pa: University of Pennsylvania Press; Healing the caregiver. J Altern Complement
vision of the healing encounter. Pain Physi- 1995. Med. 2002;8:917-920.
cian. 2006;9:352-360. 8. Klein EJ, Jackson C, Kratz L, et al. Teaching 15. Rosenzweig S, Reibel DK, Greeson JM,
2. Benbasset J, Baumal R, Borkan JM, Ber R. professionalism to residents. Acad Med. Brainard GC, Hojat M. Mindfulness-based
Overcoming barriers to teaching the behav- 2003;78:26-34. stress reduction lowers psychological dis-
ioral and social sciences to medical stu- 9. Gianakos D. Alternative healer— on being tress in medical students. Teach Learn Med.
dents. Acad Med. 2003;78:372-380. a doctor. Ann Intern Med. 2000;133:559. 2003;15:88-92.