Narrative medicine — the process of listening to and recording patient stories — helps physicians improve the quality of care they provide to older adults, according to the medical students and doctors involved in a new study.
To assess the value of narrative medicine practice, investigators worked with medical students and faculty members at Boston University Chobanian & Avedisian School of Medicine. The school uses the My Life, My Story (MLMS) framework to complete patient interviews during students’ geriatrics rotations in the clinic and during home visits or nursing home visits. MLMS was created by the Veterans Health Administration in 2013 to bring the patient’s voice into their medical record.
The researchers arranged group discussions with the students and individual interviews with faculty members. The researchers analyzed themes that arose during these discussions and interviews.
The information received when recording a narrative of the patient’s personal history in the medical record is valuable, the results revealed. The majority of students said that they believed the MLMS experience would positively influence the way they practiced medicine. Engaging in their patients’ stories improved the quality of their patient care, they said.
Similarly, faculty members reported that the practice of narrative medicine changed how they framed patient decisions and helped them to guide senior patients toward the most appropriate care environments and treatment modalities at the end of life.
“Much of medical training focuses on the medical problems that patients have, but it is also important to know the patient as a person,” author Shivani Kumari Jindal, MD, MPH, a geriatrician with the VA Boston Healthcare System, said. “Starting with what matters most to patients can help shape the care being discussed and offered, so it is more aligned with a person’s values, goals and life experiences.”
When providers meet patients later in older age, they sometimes forget that these patients have lived active lives before the health encounter, added co-author Megan E. Young, MD. “Narrative medicine, specifically My Life, My Story, is a tool to understand patients’ prior experiences and gain insight into the person that is sitting in the hospital bed or in the clinic.”
Full findings were published in the Journal of the American Geriatrics Society.