- Research
- Open access
- Published:
The role of patients’ stories in medicine: a systematic scoping review
BMC Palliative Care volume 22, Article number: 199 (2023)
Abstract
Background
Patients’ stories provide Palliative Care physicians with a glimpse into the former’s lives and their psycho-emotional, sociocultural, and contextual considerations. Yet, few physicians are trained to interpret and apply patients’ stories in their practice. Inherent variability in how stories are transmitted and interpreted raises questions over their potential effects on care. Amidst a dearth of accounts in Palliative Care, we map current use of patient stories to guide the training, assessment, and oversight of this ‘care influencing’ practice in medicine.
Methods
This systematic scoping review was guided by the Systematic Evidence-Based Approach (SEBA) to ensure a reproducible and structured approach. The themes and categories identified through the Split Approach’s concurrent and independent thematic and directed content analyses provided a comprehensive sketch of the included articles. The Jigsaw Perspective combined the themes and categories identified. The last stage of SEBA compared these results with two recent reviews of storytelling to ensure consistency of the domains created that guided the discussion.
Results
Ten thousand two hundred seven articles were reviewed, 963 full text articles were evaluated, and 199 articles were included. The four domains identified were study characteristics, benefits, approaches, and positive effects and concerns.
Conclusion
Stories support patient-centered, personalized, and holistic clinical care. However, variability in the stories, their interpretations and use in care decisions underscore the need for further study on the structuring, teaching, assessing, and delivery of this ‘care influencing’ practice.
Background
Sitting at the heart of physician-patient relationships are patients’ stories that supplement physicians with rich context-sensitive, culturally-pertinent, personalized, spiritual, sociocultural, relational, and psycho-emotional information about patients and their needs, goals, preferences and interests [1,2,3,4,5,6,7,8,9]. Patients’ stories contain their narratives that concern the “formalized, academic version of narrative medicine” and focus on the patient’s illness, as well as their identities, values, beliefs, and goals before their illness [10,11,12,13,14]. Stories also encompass personal, demographical, historical and psycho-sociocultural anecdotes and accounts.
Laskow et al. [1] further suggest that a patient’s storytelling injects much needed humanistic elements to care determinations. These humanistic features counterbalance the dominant evidenced-based medicine ethos in current practice to fashion person-centered care provision [15,16,17,18]. Storytelling builds trust, nurtures relationships, and encourages shared responsibility for the patient’s care [19]. Similarly, patients’ stories that are transmitted between members of the multidisciplinary care teams foster patient-centered care [20,21,22] and platform multidisciplinary team reflections [19, 23,24,25,26,27,28,29]. A better appreciation of stories told by patients thus promises to direct personalized and timely support to patients and their families. However, with variability in the structuring, assessment, and verification of patients’ stories, the interpretation and use of ‘care influencing’ patient stories have raised concerns [22, 30,31,32,33].
As we consider “What is known about storytelling in clinical practice?” and “How do physicians employ patients’ stories in clinical practice?” in the context of Palliative Care, an exploratory search suggested a dearth of data on patients’ stories (henceforth storytelling). We then expanded our focus to review storytelling in medicine.
Methods
To contend for the evolving nature of this sociocultural construct, we adopted Krishna’s Systematic Evidence-Based Approach (SEBA) to guide a systematic scoping review (SSR) (henceforth SSR in SEBA) of storytelling [34,35,36,37,38,39].
SEBA’s constructivist approach [40,41,42,43,44,45,46] and relativist lens [47,48,49,50] acknowledge storytelling as a sociocultural construct [51, 52] molded by six key elements [53]. One, individual characteristics, working styles, opportunities [54], motivations, attitudes, emotions [55], experience, skills, goals, historical, demographic [55, 56], socio-cultural [57,58,59], ideological, contextual and psycho-emotional features (henceforth accounts). Two, clinical, academic, personal, research, professional, ethical, psychosocial, emotional, cultural, organizational, societal, legal, and educational spheres of the patient and the receiving physician and healthcare professional (henceforth contextual considerations) [60]. Three, the learning objectives [61], goals [62, 63], timelines and professional standards [64, 65], codes of conduct, roles, responsibilities, expectations [66, 67], implicit norms [68], culture [69], artifacts, sociocultural norms and expectations and legal requirements at the practice site [70,71,72] (henceforth netiquette) [73] and its formal curriculum, approach, stages, assessment points, and mentoring support (henceforth standards). Four, the physician’s and the other healthcare professionals’ skills, knowledge, evolving goals, availabilities, reflective practice, motivations, levels of engagement, judgment, decisions, actions, and psycho-emotional wellbeing (henceforth developing competencies) [74]. Five, the nature, frequency, circumstances, and duration of interactions between patient and healthcare professionals (henceforth interactional considerations) [34]. Six, reflective practice and meaning making that are often informed by the healthcare professional’s reflections; clinical and practical experience; developing competencies; available guidance; and maturing belief systems (henceforth meaning making). Story telling is also influenced by the time limitations at consults and the presence of a conducive environment for sharing.
In the face of so many considerations, this SSR in SEBA charted current accounts, insights and the impact of stories; distilled key characteristics of storytelling to formulate and summarise actionable and applicable information across different settings; and highlighted gaps in current concepts [75,76,77,78,79,80,81,82]. A SSR in SEBA’s wide reach that included grey literature was also well-placed to contend with the conflation of the terms ‘narratives’ and ‘storytelling’. However, to ensure the feasibility of this project, we focused on the study of the term ‘storytelling’ and its impact upon physicians and patients.
This SSR in SEBA involved an expert team constituting a librarian from the National University of Singapore’s (NUS) Yong Loo Lin School of Medicine (YLLSoM) and local educational experts and clinicians at YLLSoM, National Cancer Centre Singapore, Palliative Care Institute Liverpool, and Duke-NUS Medical School. Supporting SEBA methodology’s iterative process [75, 83,84,85], the expert team guided each stage of SEBA (Fig. 1) [38, 75, 80, 81, 85] in order to foster a balanced, reproducible and accountable review.
The SEBA process (adapted from Krishna et al. [79])
Stage 1 of SEBA: systematic approach
The PCC (Population, Concept, Context) format [86] and the PRISMA-ScR checklist (see Additional file 1) were used to map the use of storytelling over the wide realm of clinical practice and guide the primary and secondary research questions [36, 37, 39, 75, 79, 81, 85]. The primary research question identified was: “What is known about storytelling in clinical practice amongst physicians?”. The secondary research questions identified were: “What are the features, benefits and concerns surrounding storytelling in clinical practice?” and “How do physicians employ patient stories in clinical practice?” (Table 1).
The populations focused on were the patients and physicians. We did not consider other audiences nor other healthcare professionals to limit the review and ensure its feasibility.
Searching
Independent searches of articles on storytelling in clinical practice published in PubMed, SCOPUS, ERIC, Google Scholar, Embase databases between 1st January 2000 and 31st December 2022 were conducted between 17th January 2023 and 24th April 2023. The list of titles to be reviewed was finalized during online research meetings by adopting Sandelowski and Barroso [87]’s ‘negotiated consensual validation’ [34, 75, 77, 88] that resolved discrepancies. The full search strategy may be found in Additional file 2.
Stage 2 of SEBA: split approach
Krishna’s ‘Split Approach’ was employed to strengthen the reliability of the data analysis process [40, 87, 89,90,91,92]. This saw one team of independent researchers using Braun and Clarke [93]’s approach to thematic analysis [34, 85, 94,95,96] and another team of independent researchers employing Hsieh and Shannon [97]’s approach to directed content analysis to draw ‘a priori coding categories” from Laskow et al. [1]’s review [83, 84, 98,99,100].
Braun and Clarke’s thematic analysis
The first team of researchers adopted Braun and Clarke [93]’s approach to thematic analysis in independently reviewing the included articles and plotting patterns in the data. The ‘surface’ meanings of these patterns were then adapted as codes and used to create a code book. Using the code book as a guide, the team integrated each newly emerging code with past codes in an iterative step-by-step analysis process [101]. This resulted in themes that were “defined from the raw data without any predetermined classification” [96]. Discussing their independent findings, the team then determined the final list of themes through ‘negotiated consensual validation’ [87].
Hsieh and Shannon’s directed content analysis
Simultaneously, Hsieh and Shannon [97]’s approach to directed content analysis guided the second team of researchers in their data analysis process. Here, the researchers identified and operationalized a priori coding categories [97, 102,103,104,105,106] from Laskow et al. [1]’s review [83, 84, 98,99,100]. This formed the ‘coding agenda’ [106, 107] wherein the pre-established codes were used to code the included articles—reducing contradictory data and omission of negative results commonly observed in thematic analysis [38, 83, 84, 88, 98,99,100, 108, 109]. Data uncaptured by the priori codes were given new codes [106]. Similarly, the team reached an agreement on the final categories through ‘negotiated consensual validation’ [87].
Stage 3 of SEBA: Jigsaw perspective
The Jigsaw Perspective entailed the merging of overlapping/complementary themes and categories identified in the Split Approach to create larger themes/categories [34, 76, 95].
Stage 4 of SEBA: comparison
The themes/categories identified were then compared with the key findings from Laskow et al. [1] and Frioretti et al. [2]’s reviews to ensure the consistency of this data.
Results
Of the 10,207 articles identified from the five databases, 963 full-text articles were independently reviewed, and 199 articles were included (Fig. 2). The four domains identified were study characteristics, benefits, approaches, and positive effects and concerns.
PRISMA-ScR flowchart
Domain 1. Study characteristics
A total of 137 of the 199 (68.5%) publications on storytelling originated from the United States of America. The remaining contributions were derived from other regions of the world, including the United Kingdom (7.5%), Canada (5.5%) and parts of Asia (5.5%). Most accounts were situated in the post-graduate setting (53%) and took the form of author insights and reflections (24%), teaching and advice on program design (26%), use in the exploration of medical ethics (12%), shared experiences (31%), or public education (6%). Additional file 3 describes the study characteristics of the included articles in more detail.
Domain 2. Benefits
Of the 199 included articles, 141 articles discussed the benefits of storytelling to clinicians, and 68 articles discussed benefits to patients where some articles discussed the benefits to both parties. These benefits are summarized in Table 2.
In brief, stories helped physicians improve their patient care competencies, and enhanced moral reasoning. Stories also aided in nurturing a physician’s individual and professional development. For patients, the individual benefits of storytelling included improved psychological and physical well-being, as well as enhanced individualized care. On a societal level, the benefits to larger society extended to improved patient advocacy and personalized care.
Domain 3. Approaches
Many current accounts structured their stories on Joseph Campbell’s hero’s journey, or the monomyth perspective (initiation, conflict, and resolution) and its subplots [265, 282,283,284]. These articles similarly described a hero, their initial context, their experience with a life-altering encounter that changed their lives, how they overcame challenges and were ultimately transformed [265, 282,283,284].
Other articles discussed the use of storytelling around Charon’s concept [19, 135, 169]. Here, these accounts echoed Charon’s posit that to be able to interpret, respond to, and be moved by patients’ stories, stories ought to have a frame (why the story was being told and its purpose), a clear timeline (both the chronological trajectory and the significance of time in the story), plot (what happened), desire (what motivated the narrator to keep telling and the audience to keep listening to the story), and tone (language and metaphor).
A number of accounts also discussed Frank [173, 285]’s approach in categorising their accounts into three forms: restitution (a plot-based story), chaos (the messy experience of illness), and quest (the lessons learned through the journey of illness). Gu [286] also suggested that storytelling revealed the dialogue between the main character (who might be the storyteller) and their roles as counsellor and listener.
Moreover, Rivkin [193] noted that stories were framed with the audience and context in mind—underlining the role, talent and experience of the storyteller, the relevance of the story to the discussion, its ability to engage the audience and the appropriateness of the content. Sandars [284, 287] further suggested that the impact of stories were enriched by its credibility that sought to balance the need for the objectivity of evidence-based medicine and the narrative subjectivity of both patients’ and clinicians’ lived experiences [131].
Domain 4. Positive effects and concerns
The absence of formal assessments of storytelling on patients and physicians left much to be inferred. These considerations underlined the need for closer study of stories and how they were retold. Even within the multidisciplinary approach of Palliative Care settings, the risk of ill-equipped physicians misinterpreting patients’ stories and inadvertently affecting decisions on care persisted [30, 32, 33, 180, 182]. The positive and negative impacts of patients’ stories on professional, personal and interpersonal development, as well as patient-physician relationships, are summarized in Table 3.
These long-term effects on the physician underscored the need for timely, personalized and longitudinal support, assessments and remediation, alongside a place for a learning portfolio to guide and mentor a physician’s professional and personal development [157, 170].
Stage 5 of SEBA: analysis of evidence-based and non-data driven literature
With nearly half the included articles drawn from non-data-based articles (grey literature, opinion, perspectives, editorial, letters), themes from these sources were compared with themes derived from evidence-based peer-reviewed sources. This process revealed similar themes and categories in the two groups. We thus concluded that data from non-data-based articles did not introduce any untoward biases to our analysis.
Discussion
Stage 6 of SEBA: synthesis of discussion
In answering its primary research question, “What is known about storytelling in clinical practice?”, this SSR in SEBA reveals widespread albeit informal, unstructured use of storytelling in medical practice that molds the physician-patient relationship, informs clinical decisions, and shapes practice. Some appreciation as to the extent of these effects becomes apparent as we address our secondary research question, “What are the features, benefits and concerns surrounding storytelling in clinical practice?”. The impacts of stories are summarized in Table 3.
When considering “How do physicians employ patient stories in clinical practice?”, our findings do suggest that current concerns about the unguided and unverified use of stories to influence care determinations merit closer scrutiny. Indeed, by virtue of their sociocultural roots and their variable structure, content, goals, nature, chronology and even the subject matter, the threat of variability and misinterpretation of stories runs the risks of inadequate and or inappropriate patient care, mistrust, and even a break in the physician–patient relationship.
However, the benefits of storytelling cannot be understated, particularly within a clinical team. Returning to our focus in the Palliative Care setting, bringing in a multidisciplinary team with inputs from nurses, medical social workers, psychologists, physiotherapists, occupational therapists, and other members of the team provide greater depth and may help verify accounts from other sources and situations. The presence of various team members, especially nurses, psychologists, counsellors, members of the chaplaincy team and social workers, attenuates the effects posed by the absence of a formal training process for physicians on the use of stories and the lack of assessment of their ‘narrative competence’ [83, 295,296,297,298]. Here, the Palliative Care team could temper inaccuracies and paint a holistic perspective of a patient’s story. This, however, does not negate the need for training of physicians. This training should be context sensitive and appropriate to the practice settings and be focused on enhancing understanding patients and their needs over time.
Further, the Palliative Care team also serves a key role in supporting physicians and one another as they confront the effects of emotional, traumatic, and difficult stories [34, 35, 53, 81]. Indeed, whilst there was only brief mention of it in this SSR in SEBA, the potential for vicarious trauma [33, 129, 157, 197] cannot be discounted. Described as a “transformation in the therapists’ inner experience, resulting from empathic engagement with clients’ trauma material [and] … the cumulative, transformative effect upon the trauma therapist, of working with survivors of traumatic life events…[,] a natural outcome of working with traumatised patients”[299], Ho and colleagues reveal concerning and long term effects of vicarious trauma upon clinicians that could be assuaged with early diagnosis and support. Here, the Palliative Care team provides a platform for just support.
Limitations
Our exclusion of healthcare professionals, such as nurses and medical social workers, to confine this review and ensure its feasibility has limited the scope and applicability of these findings. Similarly, excluding family members and care providers, particularly when taken in the Southeast Asian context where stories, care and autonomy are shared, further limits the ease of extrapolating these findings. Moreover, extrapolating accounts of storytelling from general medical settings to the Palliative Care setting also remains unproven and warrants closer scrutiny.
Including articles in or translated into English may have also restricted the search results. As most of the data were drawn from North America and Europe, they may not necessarily be transferable beyond these regions, in light of the socioculturally-sensitive nature of storytelling and stories.
Conclusion
Given the benefits of storytelling, as well as an increasing interest and general expansion of narrative medicine within medical practice, we believe that designing a formal means of assessing and structuring stories is essential, as should be efforts to better equip physicians to listen, interpret, respond to, and be moved by patients’ stories [19, 169]. In the absence of data on the impact of cultural sensitivity [294, 300,301,302,303], contextual appreciation, vicarious trauma [33, 129, 157], and empathy [88] amongst physicians, storytelling’s sociocultural roots and individualized lens should be evaluated as a means of supporting and training for physicians. We believe this is especially relevant to Palliative Care, Rehabilitation Medicine and geriatrics. It is to this and the appreciation of storytelling in Palliative Care that we will focus our efforts as we hope to continue this discussion.
Availability of data and materials
All data generated or analysed during this review are included in this published article.
Abbreviations
- SEBA:
-
Systematic Evidence Based Approach
- SSR:
-
Systematic Scoping Review
- PCC:
-
Population, Concept, Context
- PIF:
-
Professional Identity Formation
References
Laskow T, Small L, Wu DS. Narrative interventions in the palliative care setting: a scoping review. J Pain Symptom Manage. 2019;58(4):696–706.
Fioretti C, Mazzocco K, Riva S, Oliveri S, Masiero M, Pravettoni G. Research studies on patients’ illness experience using the Narrative Medicine approach: a systematic review. BMJ Open. 2016;6(7):e011220.
Youell J, Ward A. Why use storytelling in palliative care? : ehospice; 2016. Available from: https://ehospice.com/uk_posts/why-use-storytelling-in-palliative-care/.
Forbes K. Narrative and storytelling in palliative care education and training. 2009. In: Narrative and Stories in Health Care: Illness, dying and bereavement. Oxford University Press. p. 111–26. Available from: https://doi.org/10.1093/acprof:oso/9780199546695.003.0008. Cited 3/24/2023.
Ryu S, Price SK. Embodied storytelling and meaning-making at the end of life: voicingHan avatar life-review for palliative care in cancer patients. Arts Health. 2022;14(3):326–40.
Williams L, Gott M, Moeke-Maxwell T, Black S, Kothari S, Pearson S, et al. Can digital stories go where palliative care research has never gone before? A descriptive qualitative study exploring the application of an emerging public health research method in an indigenous palliative care context. BMC Palliat Care. 2017;16(1):46.
Stanley P, Hurst M. Narrative palliative care: a method for building empathy. J Soc Work End Life Palliat Care. 2011;7(1):39–55.
Romanoff BD, Thompson BE. Meaning construction in palliative care: the use of narrative, ritual, and the expressive arts. Am J Hosp Palliat Care. 2006;23(4):309–16.
Wittenberg-Lyles E, Greene KA, Sanchez-Reilly SE. The palliative power of storytelling: using published narratives as a teaching tool in end-of-life care. J Hosp Palliat Nurs. 2007;9:198–205.
Roscoe LA. Healing the physician’s story: a case study in narrative medicine and end-of-life care. Narrat Inq Bioeth. 2012;2(1):65–72.
Charon R. Narrative medicine in the international education of physicians. Presse Med. 2013;42(1):3–5.
Erogul M, Chung A, Schiller J. Formalized storytelling in emergency medicine. Curr Res Emerg Med. 2022;2(1).
Hegele A. Indigenous poetics and narrative medicine. Synapsis. 2017.
Osipov R. Healing narrative-ethics and writing about patients. Virtual Mentor. 2011;13(7):420–4.
Boston P, Bruce A, Schreiber R. Existential suffering in the palliative care setting: an integrated literature review. J Pain Symptom Manage. 2011;41(3):604–18.
Delgado-Guay MO, Hui D, Parsons HA, Govan K, De la Cruz M, Thorney S, et al. Spirituality, religiosity, and spiritual pain in advanced cancer patients. J Pain Symptom Manage. 2011;41(6):986–94.
Chochinov HM. Thinking outside the box: depression, hope, and meaning at the end of life. J Palliat Med. 2003;6(6):973–7.
Corn BW. Ending end-of-life phobia–a prescription for enlightened health care reform. N Engl J Med. 2009;361(27):e63.
Charon R. Narrative medicine: a model for empathy, reflection, profession, and trust. JAMA. 2001;286(15):1897–902.
Groopman J. Why Storytelling Is Part of Being a Good Doctor: New Yorker; 2022. Available from: https://www.newyorker.com/magazine/2022/07/25/why-storytelling-is-part-of-being-a-good-doctor-all-that-moves-us-jay-wellons.
Chekhov AP. Misery. 2006. In: The Schoolmistress, and Other Stories. Project Gutenberg. Available from: https://www.gutenberg.org/files/1732/1732-h/1732-h.htm.
Nash W, Erondu M, Childress A. Expanding narrative medicine through the collaborative construction and compelling performance of stories. J Med Human. 2023.
Silverman E. Sharing and healing through storytelling in medicine. JAMA Intern Med. 2017;177(10):1409–10.
Bohanon M. The evolving field of narrative medicine reaches the ‘Core of the Human Condition’. INSIGHT Into Diversity. 2019.
Krisberg K. Narrative Medicine: every patient has a story: Association of American Medical Colleges; 2017. Available from: https://www.aamc.org/news-insights/narrative-medicine-every-patient-has-story.
Mehrlich KD, Wasmuth S. Tell My Story: narrative medicine as a unique approach to forensic mental health intervention: American Occupational Therapy Association; 2019. Available from: https://www.aota.org/publications/ot-practice/ot-practice-issues/2019/narrative-medicine.
Samuel S. This doctor is taking aim at our broken medical system, one story at a time: Vox; 2020. Available from: https://www.vox.com/the-highlight/2020/2/27/21152916/rita-charon-narrative-medicine-health-care.
Wong C. How Narrative Medicine Might Benefit You Verywell Health; 2020. Available from: https://www.verywellhealth.com/narrative-medicine-benefits-uses-and-tips-4143186.
Zaharias G. What is narrative-based medicine? Narrative-based. Med Can Fam Phys. 2018;64(3):176–80.
Charon R. Literature and medicine: origins and destinies. Acad Med. 2000;75(1):23–7.
Cox E. Narrative Medicine: the Importance of Storytelling in Health Care: USNews; 2019. Available from: https://health.usnews.com/health-care/for-better/articles/narrative-medicine-the-importance-of-storytelling-in-health-care.
Lehmann S. Storytelling in Medicine: CLOSLER; 2018. Available from: https://closler.org/connecting-with-patients/storytelling-in-medicine.
Jáuregui-Lobera I, Martínez-Gamarra M, Montes-Martínez M, Martínez-Quiñones J. Storytelling as instrument of communication in health contexts. JONNPR. 2020;5(8):863–90.
Quek CWN, Ong R, Wong R, Chan S, Chok A, Shen G, et al. Systematic scoping review on moral distress among physicians. BMJ Open. 2022;12:e064029.
Ho C, Kow CS, Chia C, Low J, Lai M, Lauw S-K, et al. The impact of death and dying on the personhood of medical students: a systematic scoping review. BMC Med Educ. 2020;20:516.
Kuek J, Ngiam L, Kamal N, Chia J, Chan N, Abdurrahman A, et al. The impact of caring for dying patients in intensive care units on a physician’s personhood: a systematic scoping review. Philos Ethics Humanit Med. 2020;15:12.
Hong D, Goh J, Ong Z, Ting J, Wong M, Wu J, et al. Postgraduate ethics training programs: a systematic scoping review. BMC Med Educ. 2021;21:338.
Tan XH, Foo MA, Lim SLH, Lim MBXY, Chin AMC, Zhou J, et al. Teaching and assessing communication skills in the postgraduate medical setting: a systematic scoping review. BMC Med Educ. 2021;21(1):483.
Hong D, Lim A, Tan R, Ong YT, Pisupati A, Chong E, et al. A systematic scoping review on portfolios of medical educators. J Med Educ Curric Dev. 2021;8:238212052110003.
Ng YX, Koh ZYK, Yap HW, Tay KT, Tan XH, Ong YT, et al. Assessing mentoring: a scoping review of mentoring assessment tools in internal medicine between 1990 and 2019. PLoS One. 2020;15(5):e0232511.
Bousquet J, Schunemann HJ, Samolinski B, Demoly P, Baena-Cagnani CE, Bachert C, et al. Allergic Rhinitis and its Impact on Asthma (ARIA): achievements in 10 years and future needs. J Allergy Clin Immunol. 2012;130(5):1049–62.
Bok C, Ng CH, Koh JWH, Ong ZH, Ghazali HZB, Tan LHE, et al. Interprofessional communication (IPC) for medical students: a scoping review. BMC Med Educ. 2020;20(1):372.
Nur Haidah Ahmad Kamal LHET, Ruth Si Man Wong, Ryan Rui Song Ong, Ryan, Ern Wei Seow EKYL, Zheng Hui Mah, Min Chiam, Annelissa Mien Chew Chin, Jamie Xuelian Zhou, Gillian Li Gek Phua, Eng Koon Ong, Jin Wei Kwekc, Kiley Wei-Jen Loh and, Krishna LKR. Enhancing education in palliative medicine: the role of systematic scoping reviews. Palliat Med Care. 2020;7(1):1–11.
Ryan Rui Song Ong REWS, Ruth Si Man Wong. A systematic scoping review of narrative reviews in palliative medicine education. Palliat Med Care. 2020;7(1):1–22.
Zheng Hui Mah RSMW, Ryan Ern Wei Seow Eleanor Kei Ying Loh, Nur Haidah, Ahmad Kamal RRSO, Lorraine Hui En Tan, Min Chiam, Annelissa Mien Chew Chin,, Jamie Xuelian Zhou GLGP, Yoke-Lim Soong, Jin Wei Kwek, and Lalit Kumar Radha Krishna. A systematic scoping review of systematic reviews in palliative medicine education. Palliat Med Care. 2020;7(1):1–12.
Wyatt TR, Rockich-Winston N, White D, Taylor TR. “Changing the narrative”: a study on professional identity formation among Black/African American physicians in the U.S. Adv Health Sci Educ Theory Pract. 2021;26(1):183–98.
Pring R. The ‘False Dualism’ of educational research. J Philos Educ. 2000;34(2):247–60.
Crotty M. The foundations of social research: Meaning and perspective in the research process: Sage; 1998.
Ford DW, Downey L, Engelberg R, Back AL, Curtis JR. Discussing religion and spirituality is an advanced communication skill: an exploratory structural equation model of physician trainee self-ratings. J Palliat Med. 2012;15(1):63–70.
Schick-Makaroff K, MacDonald M, Plummer M, Burgess J, Neander W. What synthesis methodology should I use? A review and analysis of approaches to research synthesis. AIMS public health. 2016;3(1):172.
Deshpande AD, Sanders Thompson VL, Vaughn KP, Kreuter MW. The use of sociocultural constructs in cancer screening research among African Americans. Cancer Control. 2009;16(3):256–65.
Stephens MB, Bader KS, Myers KR, Walker MS, Varpio L. Examining professional identity formation through the ancient art of mask-making. J Gen Intern Med. 2019;34(7):1113–5.
Ho CY, Lim NA, Rahman NDA, Chiam M, Zhou JX, Phua GLG, et al. Physician-patient boundaries in palliative care. BMC Palliat Care. 2023;22(1):41.
Crampton PES, Afzali Y. Professional identity formation, intersectionality and equity in medical education. Med Educ. 2021;55(2):140–2.
Wyatt TR, Balmer D, Rockich-Winston N, Chow CJ, Richards J, Zaidi Z. ‘Whispers and shadows’: a critical review of the professional identity literature with respect to minority physicians. Med Educ. 2021;55(2):148–58.
Chow CJ, Byington CL, Olson LM, Ramirez KPG, Zeng S, López AM. A conceptual model for understanding academic physicians’ performances of identity: findings from the University of Utah. Acad Med. 2018;93(10):1539–49.
Surbone A, Baider L. Personal values and cultural diversity. J Med Person. 2013;11(1):11–8.
Koon OE, Krishna LKR. Perspective from Singapore. Asian Bioeth Rev. 2014;6(4):420–7.
Ong EK, Krishna LK, Neo PSH. The sociocultural and ethical issues behind the decision for artificial hydration in a young palliative patient with recurrent intestinal obstruction. Ethics Med Int J Bioethics. 2015;31:39.
Venktaramana V, Ong YT, Yeo JW, Pisupati A, Krishna LKR. Understanding mentoring relationships between mentees, peer and senior mentors. BMC Med Educ. 2023;23(1):76.
Rosenthal S, Howard B, Schlussel YR, Herrigel D, Smolarz BG, Gable B, et al. Humanism at heart: preserving empathy in third-year medical students. Acad Med. 2011;86(3):350–8.
Wright SM, Levine RB, Beasley B, Haidet P, Gress TW, Caccamese S, et al. Personal growth and its correlates during residency training. Med Educ. 2006;40(8):737–45.
Levine RB, Haidet P, Kern DE, Beasley BW, Bensinger L, Brady DW, et al. Personal growth during internship. J Gen Intern Med. 2006;21(6):564–9.
Fischer MA, Haley H-L, Saarinen CL, Chretien KC. Comparison of blogged and written reflections in two medicine clerkships. Med Educ. 2011;45(2):166–75.
Kern DE, Wright SM, Carrese JA, Lipkin M Jr, Simmons JM, Novack DH, et al. Personal growth in medical faculty: a qualitative study. West J Med. 2001;175(2):92–8.
Kimmons R, Veletsianos G. The fragmented educator 2.0: social networking sites, acceptable identity fragments, and the identity constellation. Comput Educ. 2014;72:292–301.
Gosselink MJ. Medical weblogs: advocacy for positive cyber role models. Clin Teach. 2011;8(4):245–8.
Fieseler C, Meckel M, Ranzini G. Professional personae - how organizational identification shapes online identity in the workplace. J Comput Mediat Commun. 2014;20(2):153–70.
Stokes J, Price B. Social Media, Visual Culture and Contemporary Identity. In: Callaos N, Carrasquero JV, Sánchez B, Tremante As, Welsch F, editors. 11th International Multi-Conference on Society, Cybernetics and Informatics (IMSCI 2017): International Institute of Informatics and Cybernetics; 2017. p. 159–63.
Maghrabi RO, Oakley RL, Nemati HR. The impact of self-selected identity on productive or perverse social capital in social network sites. Comput Hum Behav. 2014;33:367–71.
Hojat M, Vergare MJ, Maxwell K, Brainard G, Herrine SK, Isenberg GA, et al. The devil is in the third year: a longitudinal study of erosion of empathy in medical school. Acad Med. 2009;84(9):1182–91.
Newton BW, Barber L, Clardy J, Cleveland E, O’Sullivan P. Is there hardening of the heart during medical school? Acad Med. 2008;83(3):244–9.
Kaczmarczyk JM, Chuang A, Dugoff L, Abbott JF, Cullimore AJ, Dalrymple J, et al. e-Professionalism: a new frontier in medical education. Teach Learn Med. 2013;25(2):165–70.
Ong YT, Quek CWN, Pisupati A, Loh EKY, Venktaramana V, Chiam M, et al. Mentoring future mentors in undergraduate medical education. PLoS One. 2022;17(9):e0273358.
Teo K, Teo M, Pisupati A, Ong R, Goh C, Seah C, et al. Assessing professional identity formation (PIF) amongst medical students in Oncology and Palliative Medicine postings: a SEBA guided scoping review. BMC Palliat Care. 2022;21:200.
Chua K, Quah E, Lim Y, Goh C, Lim J, Wan D, et al. A systematic scoping review on patients’ perceptions of dignity. BMC Palliative Care. 2022;21:118.
Ong R, Wong R, Chee R, Quek CWN, Burla N, Loh C, et al. A systematic scoping review moral distress amongst medical students. BMC Med Educ. 2022;22(1):466.
Toh R, Koh K, Lua J, Wong R, Quah E, Panda A, et al. The role of mentoring, supervision, coaching, teaching and instruction on professional identity formation: a systematic scoping review. BMC Med Educ. 2022;22(1):531.
Krishna L, Tan L, Ong YT, Tay KT, Hee J, Chiam M, et al. Enhancing mentoring in palliative care: an evidence based mentoring framework. J Med Educ Curric Dev. 2020;7:238212052095764.
Goh S, Wong RSM, Quah ELY, Chua KZY, Lim WQ, Ng ADR, et al. Mentoring in palliative medicine in the time of covid-19: a systematic scoping review. BMC Med Educ. 2022;22(1):359.
Ho CY, Lim NA, Ong YT, Lee ASI, Chiam M, Gek GPL, et al. The impact of death and dying on the personhood of senior nurses at the National Cancer Centre Singapore (NCCS): a qualitative study. BMC Palliat Care. 2022;21(1):83.
Chong E, Wang M, Lim J, Shen G, Chow M, Koh K, et al. Surgical portfolios: a systematic scoping review. Surg Pract Sci. 2022;10:100107.
Ong Z, Tan L, Ghazali H, Ong Y, Koh J, Ang R, et al. A Systematic scoping review on pedagogical strategies of interprofessional communication for physicians in emergency medicine. J Med Educ Curric Dev. 2021;16(8):23821205211041790.
Sarraf-Yazdi S, Teo Y, How A, Teo Y, Goh S, Kow C, et al. A scoping review of professional identity formation in undergraduate medical education. J Gen Intern Med. 2021;36:3511–21.
Jacquelin Jia Qi T, Gillian Li Gek P, Daniel Zhihao H, Bertrand Kai Yang L, Annabelle Jia Sing L, Eleanor Jia Xin C, et al. Evidence-guided approach to portfolio-guided teaching and assessing communications, ethics and professionalism for medical students and physicians: a systematic scoping review. BMJ Open. 2023;13(3):e067048.
Peters M, Godfrey C, McInerney P, Soares C, Khalil H, Parker D. Methodology for JBI Scoping Reviews. 2015. p. 1–24.
Sandelowski M, Barroso J. Handbook for synthesizing qualitative research. Springer publishing company; 2006.
Zhou YC, Tan SR, Tan CGH, Ng MSP, Lim KH, Tan LHE, et al. A systematic scoping review of approaches to teaching and assessing empathy in medicine. BMC Med Educ. 2021;21(1):292.
Wen Jie Chua CWSC, Fion Qian Hui Lee, Eugene Yong Hian Koh, Ying Pin Toh, Stephen Mason, Lalit Kumar Radha Krishna. Structuring mentoring in medicine and surgery. A systematic scoping review of mentoring programs between 2000 and 2019. J Continuing Educ Health Prof. 2020;40(3):158–68.
Peters MD, Godfrey CM, Khalil H, McInerney P, Parker D, Soares CB. Guidance for conducting systematic scoping reviews. Int J Evid Based Healthc. 2015;13(3):141–6.
Pham MT, Rajic A, Greig JD, Sargeant JM, Papadopoulos A, McEwen SA. A scoping review of scoping reviews: advancing the approach and enhancing the consistency. Res Synth Methods. 2014;5(4):371–85.
Sambunjak D, Straus SE, Marusic A. A systematic review of qualitative research on the meaning and characteristics of mentoring in academic medicine. J Gen Intern Med. 2010;25(1):72–8.
Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101.
Chia E, Huang H, Goh S, Peries M, Lee C, Tan L, et al. A systematic scoping review of teaching and evaluating communications in the intensive care unit. Asia Pacific Scholar. 2021;6:3–29.
Quah E, Chua K, Lua J, Wan D, Chong C, Lim Y, et al. A systematic review of stakeholder perspectives of dignity and assisted dying. J Pain Symptom Manag. 2022;65.
Cassol H, Pétré B, Degrange S, Martial C, Charland-Verville V, Lallier F, et al. Qualitative thematic analysis of the phenomenology of near-death experiences. PLoS One. 2018;13(2):e0193001.
Hsieh H-F, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005;15(9):1277–88.
Vig P, Lim J, Lee R, Huang H, Tan X, Lim W, et al. Parental bereavement - impact of death of neonates and children under 12 years on personhood of parents: a systematic scoping review. BMC Palliat Care. 2021;20(1):136.
Chan N, Chia J, Ho C, Ngiam L, Kuek J, Ahmad Kamal NH, et al. Extending the ring theory of personhood to the care of dying patients in intensive care units. Asian Bioeth Rev. 2021;14(1):71–86.
Teo Y, Peh T, Abdurrahman A, Lee A, Chiam M, Fong W, et al. A modified Delphi approach to enhance nurturing of professionalism in postgraduate medical education in Singapore. Singapore Med J. 2021; Epub ahead of print.
Voloch K-A, Judd N, Sakamoto KJ. An innovative mentoring program for Imi Ho’ola Post-Baccalaureate students at the University of Hawai’i John A. Burns Schl Med. 2007;66(4):102–3.
Neal JW, Neal ZP, Lawlor JA, Mills KJ, McAlindon KJA, Health PiM, et al. What makes research useful for public school educators? Adm Policy Ment Health. 2018;45(3):432–46.
Wagner-Menghin M, de Bruin A, van Merriënboer JJ. Monitoring communication with patients: analyzing judgments of satisfaction (JOS). Adv Health Sci Educ Theory Pract. 2016;21(3):523–40.
Humble Á M. Technique triangulation for validation in directed content analysis. Int J Qual Methods. 2009;8(3):34–51.
Elo S, Kyngäs H. The qualitative content analysis process. J Adv Nurs. 2008;62(1):107–15.
Mayring P. Qualitative content analysis. Forum Qual Soc Res. 2004;1(2):159–76.
Kibiswa NK. Directed qualitative content analysis (DQlCA): a tool for conflict analysis. Qual Rep. 2019;24(8):2059–79.
Wong MK, Hong DZH, Wu J, Ting JJQ, Goh JL, Ong ZY, et al. A systematic scoping review of undergraduate medical ethics education programs from 1990 to 2020. Med Teach. 2022;44(2):167–86.
Nowell LS, Norris JM, White DE, Moules NJ. Thematic analysis: Striving to meet the trustworthiness criteria. Int J Qual Methods. 2017;16(1):1609406917733847.
Baikie KA, Wilhelm K. Emotional and physical health benefits of expressive writing. Adv Psychiatr Treat. 2005;11(5):338–46.
Fivush R. The power of stories for patients and providers. J Human Rehabil. 2017.
Beresford P. Including our self in struggle: challenging the neo-liberal psycho-system’s subversion of us, our ideas and action. Can J Disabil Stud. 2019;8(4):31–59.
González-Sanguino C, Potts LC, Milenova M, Henderson C. Time to Change’s social marketing campaign for a new target population: results from 2017 to 2019. BMC Psychiatry. 2019;19(1):417.
Harter LM, Ellingson LL, Yamasaki J, Hook C, Walker T. Defining moments…telling stories to foster well-being, humanize healthcare, and advocate for change. Health Commun. 2020;35(2):262–7.
Kwan CK. A qualitative inquiry into the human library approach: facilitating social inclusion and promoting recovery. Int J Environ Res Public Health. 2020;17(9):3029.
Brandeland MA. The labor of story telling. JAMA. 2022;327(10):925–6.
Accreditation Council for Graduate Medical Education. #ACGME2022 Session Summary: Fostering Meaning and Connections through Storytelling and Written Reflection Accreditation Council for Graduate Medical Education; 2022. Available from: https://www.acgme.org/newsroom/blog/2022/acgme2022-session-summary-fostering-meaning-and-connections-through-storytelling-and-written-reflection/.
Ethics UHSACfMHa. HIV Storytelling Project: UT Health San Antonio. Available from: https://www.texashumanities.org/hivstorytellingproject/.
Humanities WUP. Stories of Illness and Health: Western University Public Humanities. Available from: https://www.uwo.ca/arts/publichumanities/of_interest/stories.html.
Greene MG, Hoffman S, Charon R, Adelman R. Psychosocial concerns in the medical encounter: a comparison of the interactions of doctors with their old and young patients. Gerontologist. 1987;27(2):164–8.
Charon R. To build a case: medical histories as traditions in conflict. Lit Med. 1992;11(1):115–32.
Selzer R, Charon R. Stories for a humanistic medicine. Acad Med. 1999;74(1):42–4.
Charon R. The body and the self: the seamless experience of being. Med Humanit Rev. 2002;16:40–6.
Charon R. Narrative and medicine. N Engl J Med. 2004;350(9):862–4.
DasGupta S, Charon R. Personal illness narratives: using reflective writing to teach empathy. Acad Med. 2004;79(4):351–6.
Pullman D, Bethune C, Duke P. Narrative means to humanistic ends. Teach Learn Med. 2005;17(3):279–84.
Wiltshire J. Medical history from the viewpoint of the patient. Intern Med J. 2005;35(3):193–4.
Poirier S. Medical education and the embodied physician. Lit Med. 2006;25(2):522–52.
Charon R. What to do with stories: the sciences of narrative medicine. Can Fam Phys. 2007;53(8):1265–7.
Madjar I, Kacen L, Ariad S, Denham J. Telling their stories, telling our stories: physicians’ experiences with patients who decide to forgo or stop treatment for cancer. Qual Health Res. 2007;17(4):428–41.
Charon R, Wyer P. Narrative evidence based medicine. Lancet. 2008;371(9609):296–7.
Magazine YM. A doctor’s passion for medical storytelling. Yale Medicine Magazine. 2008 27/03/2023. Available from: https://medicine.yale.edu/news/yale-medicine-magazine/article/a-doctors-passion-for-medical-storytelling/.
Wood W. Telling stories: our cancer patients as people: Healio; 2009. Available from: https://www.healio.com/news/hematology-oncology/20120325/telling-stories-our-cancer-patients-as-people.
Garden R. Telling stories about illness and disability: the limits and lessons of narrative. Perspect Biol Med. 2010;53(1):121–35.
Shapiro J, Bezzubova E, Koons R. Medical students learn to tell stories about their patients and themselves. Virtual Mentor. 2011;13(7):466–70.
Charon R. The reciprocity of recognition–what medicine exposes about self and other. N Engl J Med. 2012;367(20):1878–81.
Munn JC. Telling the story: perceptions of hospice in long-term care. Am J Hosp Palliat Care. 2012;29(3):201–9.
Yollin P. Physicians Emphasize Importance of Story Telling to Advance Patient Care: University of California San Francisco; 2012. Available from: https://www.ucsf.edu/news/2012/01/104056/physicians-emphasize-importance-story-telling-advance-patient-care.
Arntfield SL, Slesar K, Dickson J, Charon R. Narrative medicine as a means of training medical students toward residency competencies. Patient Educ Couns. 2013;91(3):280–6.
Charon R. Narrative medicine: caring for the sick is a work of art. JAAPA. 2013;26(12):8.
de Leeuw S. Telling stories about stories. Can Fam Physician. 2014;60(1):65–7.
Pethes N. Telling cases: writing against genre in medicine and literature. Lit Med. 2014;32(1):24–45.
Sarvimäki A. Healthy ageing, narrative method and research ethics. Scand J Public Health Supplement. 2015;16:57–60.
Builders P. Medical Practice Marketing: The Art and Science of Storytelling: Practice Builders; 2017. Available from: https://www.practicebuilders.com/blog/medical-practice-marketing-the-art-and-science-of-storytelling/.
Charon R. To see the suffering. Acad Med. 2017;92(12):1668–70.
Gallagher S. This Class Puts Stories at the Heart of Medicine and Health: Duke Global Health Institute; 2018. Available from: https://globalhealth.duke.edu/news/class-puts-stories-heart-medicine-and-health.
Lapite A. Embracing patient stories: The benefits of narrative medicine: Wolters Kluwer; 2020. Available from: https://www.wolterskluwer.com/en/expert-insights/embracing-patient-stories-the-benefits-of-narrative-medicine.
Charon R. Knowing, seeing, and telling in medicine. Lancet. 2021;398(10316):2068–70.
Czerska I. Narrative medicine as an opportunity to humanize healthcare in a post-pandemic reality. Eur Res Stud J. 2021;24(3):949–56.
Zurzycka P, Wojtas K. Narration in medical care. Selected aspects of narrative medicine in psychiatry. Nurs Problems. 2021;29(1):38–43.
Llewellyn-Beardsley J, Rennick-Egglestone S, Pollock K, Ali Y, Watson E, Franklin D, et al. 'Maybe I Shouldn’t Talk’: the role of power in the telling of mental health recovery stories. Qual Health Res. 2022;32(12):1828–42.
Silver M, Ohnigian S, Silk H, Ennis M, Savageau J. Med moth: a storytelling platform for improving wellness in medical education. Int J Med Stud. 2022;9(4):300–3.
Alcauskas M, Charon R. Right brain: reading, writing, and reflecting: making a case for narrative medicine in neurology. Neurology. 2008;70(11):891–4.
Calman K. A study of storytelling, humour and learning in medicine. Clin Med (Lond). 2001;1(3):227–9.
Cappuccio A, Sanduzzi Zamparelli A, Verga M, Nardini S, Policreti A, Porpiglia PA, et al. Narrative medicine educational project to improve the care of patients with chronic obstructive pulmonary disease. ERJ Open Res. 2018;4(2):00155–2017.
Charon R, DasGupta S. Narrative medicine, or a sense of story. Lit Med. 2011;29(2):vii–xiii.
Cunningham H, Taylor D, Desai UA, Quiah SC, Kaplan B, Fei L, et al. Looking back to move forward: first-year medical students’ meta-reflections on their narrative portfolio writings. Acad Med. 2018;93(6):888–94.
Daryazadeh S, Adibi P, Yamani N. The role of narrative medicine program in promoting professional ethics: perceptions of Iranian medical students. J Med Ethics Hist Med. 2021;14:21.
Fenstermacher E, Longley RM, Amonoo HL. Finding the story in medicine: the use of narrative techniques in psychiatry. Psychiatr Clin North Am. 2021;44(2):263–81.
Kagawa Y, Ishikawa H, Son D, Okuhara T, Okada H, Ueno H, et al. Using patient storytelling to improve medical students’ empathy in Japan: a pre-post study. BMC Med Educ. 2023;23(1):67.
Kelsall C. Physician–author passionate about listening to patients’ stories, telling his own: Healio; 2016. Available from: https://www.healio.com/news/hematology-oncology/20160422/physicianauthor-passionate-about-listening-to-patients-stories-telling-his-own.
Kleinman A. Caregiving: the odyssey of becoming more human. Lancet. 2009;373(9660):292–3.
Salter L, Newkirk J. Collective storytelling for health: a three-part story. Storytelli Self Soc. 2019;15(1):108–29.
Schwartz BD, Horst A, Fisher JA, Michels N, Van Winkle LJ. Fostering empathy, implicit bias mitigation, and compassionate behavior in a medical humanities course. Int J Environ Res Public Health. 2020;17(7):2169.
Sequence Health. Healthcare Storytelling: Using Narratives to Transform Patient Care: Sequence Health; 2022. Available from: https://www.sequencehealth.com/blog/healthcare-storytelling-using-narratives-to-transform-patient-care.
Zhao J, Xiantao O, Li Q, Liu H, Wang F, Li Q, et al. Role of narrative medicine-based education in cultivating empathy in residents. BMC Med Educ. 2023;23(1):124.
Baker CJ, Clark SB. Taking a history, telling a tale: a story-telling approach to teaching history-taking skills. Clin Teach. 2008;5(3):154–8.
Carolyn E. Ethics in two voices telling tales on neighbors. Int Rev Qual Res. 2009;2(1):3–27.
Charon R. Narrative medicine: honoring the stories of illness. New York, NY: Oxford University Press; 2006. p. xvi, 266– xvi.
Charon R, Hermann N, Devlin MJ. Close reading and creative writing in clinical education: teaching attention, representation, and affiliation. Acad Med. 2016;91(3):345–50.
Gowda D, Curran T, Khedagi A, Mangold M, Jiwani F, Desai U, et al. Implementing an interprofessional narrative medicine program in academic clinics: Feasibility and program evaluation. Perspect Med Educ. 2019;8(1):52–9.
Greene MG, Adelman RD, Charon R, Friedmann E. Concordance between physicians and their older and younger patients in the primary care medical encounter. Gerontologist. 1989;29(6):808–13.
Ingram C. Storytelling in medical education, clinical care, and clinician well-being. Arch Med Health Sci. 2021;9(2):337–44.
Charon R. Narrative medicine: attention, representation. Affiliation Narrat. 2005;13(3):261–70.
Charon R, Fox RC. Critiques and remedies: medical students call for change in ethics teaching. JAMA. 1995;274(9):767, 71.
DasGupta S, Meyer D, Calero-Breckheimer A, Costley AW, Guillen S. Teaching cultural competency through narrative medicine: intersections of classroom and community. Teach Learn Med. 2006;18(1):14–7.
Kamaka ML. Designing a cultural competency curriculum: asking the stakeholders. Hawaii Med J. 2010;69(6 Suppl 3):31–4.
Kumagai AK, Lypson ML. Beyond cultural competence: critical consciousness, social justice, and multicultural education. Acad Med. 2009;84(6):782–7.
Kyratzis A. Language and culture socialization through personal story-telling practice. Hum Dev. 2005;48(3):146–50.
Saffran L. Public health storytelling practice. Lancet. 2021;397(10284):1536–7.
Shapiro J, Lie D, Gutierrez D, Zhuang G. “That never would have occurred to me”: a qualitative study of medical students’ views of a cultural competence curriculum. BMC Med Educ. 2006;6:31.
Zarei A, Mojtahedzadeh R, Mohammadi A, Sandars J, Hossein Emami SA. Applying digital storytelling in the medical oncology curriculum: effects on students’ achievement and critical thinking. Ann Med Surg (Lond). 2021;70:102528.
Hammer RR, Rian JD, Gregory JK, Bostwick JM, Barrett Birk C, Chalfant L, et al. Telling the patient’s story: using theatre training to improve case presentation skills. Med Humanit. 2011;37(1):18–22.
Fins JJ. Giving voice to consciousness. Camb Q Healthc Ethics. 2016;25(4):583–99.
Frattaroli J. Experimental disclosure and its moderators: a meta-analysis. Psychol Bull. 2006;132(6):823–65.
Charon R. Commentary on “Creative Expressive Encounters in Health Ethics Education: Teaching Ethics as Relational Engagement.” Teach Learn Med. 2009;21(2):163–5.
Greene MG, Adelman R, Charon R, Hoffman S. Ageism in the medical encounter: an exploratory study of the doctor-elderly patient relationship. Lang Commun. 1986;6(1–2):113–24.
Inui TS, Frankel RM. Hello, stranger: building a healing narrative that includes everyone. Acad Med. 2006;81(5):415–8.
Robinson A. Narrative Medicine: U.S. Department of Veterans Affairs; 2014. Available from: https://www.va.gov/WHOLEHEALTHLIBRARY/tools/narrative-medicine.asp.
Simpson-Gervin V. Narrative Medicine and Storytelling: An Alternative Method for Healing. In: Bray P, editor. Voices of Illness: Negotiating Meaning and Identity. Leiden, The Netherlands: Brill; 2019. p. 15–31.
Willis S. Life, Death and the Stories in Between: Storytelling in Geriatric Medicine British Geriatrics Society; 2018. Available from: https://www.bgs.org.uk/resources/life-death-and-the-stories-in-between-storytelling-in-geriatric-medicine.
Boeykens D, Boeckxstaens P, Van de Velde D, De Vriendt P. “It is about telling my story in a trustful relationship” Learning about goal-oriented care through the experiences of patients with chronic conditions or multimorbidity. International Journal of Integrated Care. 2022.
Rivkin S. Scientific Storytelling for Medical Affairs: PharmExec; 2021. Available from: https://www.pharmexec.com/view/scientific-storytelling-for-medical-affairs.
Jackson D. Telling our stories of practice through the genre of the case report. Clin Case Rep. 2014;2(3):65.
Charon R. Clinical Contributions of Narrative Medicine. 2016. In: The Principles and Practice of Narrative Medicine. Oxford University Press. p. 292–310. Available from: https://doi.org/10.1093/med/9780199360192.003.0014. Cited 3/27/2023.
Medicine Sa. Why Do Stories Matter? : Stories are Medicine. Available from: http://www.storiesaremedicine.com/.
Tait GR, Hodges BD. Residents learning from a narrative experience with dying patients: a qualitative study. Adv Health Sci Educ Theory Pract. 2013;18(4):727–43.
Education DOIfRa. Storytelling reduces pain and stress, and increases oxytocin in hospitalized children: Medical Xpress; 2021. Available from: https://medicalxpress.com/news/2021-05-storytelling-pain-stress-oxytocin-hospitalized.html.
Chen PW. When Patients Share Their Stories, Health May Improve. The New York Times. 2011. Available from: https://www.nytimes.com/2011/02/10/health/views/10chen.html.
Shankar PR. Using ‘stories’ in Nepalese medical schools. Janaki Med Coll J Med Sci. 2020;8(2):1–4.
Bell B. How Storytelling Benefits the Mental Health of Medical Students: Acuity Insights; 2022. Available from: https://acuityinsights.app/2022/04/storytelling-benefits-mental-health-medical-students/.
Miller E, Balmer D, Hermann N, Graham G, Charon R. Sounding narrative medicine: studying students’ professional identity development at Columbia University College of Physicians and Surgeons. Acad Med. 2014;89(2):335–42.
Anyaegbunam JA, Sotsky J, Salib C, Kissler MJ, Jiao JM, Charon R. A piece of my mind. Five voices, one story. JAMA. 2013;310(24):2615–6.
BMJ. Telling stories and listening to them. BMJ. 2000;321:7272.
Cappuccio A, Napolitano S, Menzella F, Pellegrini G, Policreti A, Pelaia G, et al. Use of narrative medicine to identify key factors for effective doctor-patient relationships in severe asthma. Multidiscip Respir Med. 2019;14:26.
Charon R. Narrative lights on clinical acts: what we, like maisie, know. Partial Ans J Literat Hist Ideas. 2006;4(2):41–58.
Charon R. Commentary: our heads touch: telling and listening to stories of self. Acad Med. 2012;87(9):1154–6.
Clements S, Coniglio F, Mackenzie L. “I’m Not Telling an Illness Story. I’m Telling a Story of Opportunity”: making sense of voice hearing experiences. Community Ment Health J. 2020;56(2):196–205.
Cleveland EF. Telling the stories of the Health Professions Partnership Initiative. Acad Med. 2006;81(6 Suppl):S15–6.
DasGupta S. Between stillness and story: lessons of children’s illness narratives. Pediatrics. 2007;119(6):e1384–91.
Davenport NH. Medical residents’ use of narrative templates in storytelling and diagnosis. Soc Sci Med. 2011;73(6):873–81.
Divinsky M. Stories for life: introduction to narrative medicine. Can Fam Physician. 2007;53(2):203–5, 9-11.
Heiserman A, Spiegel M. Narrative permeability: crossing the dissociative barrier in and out of films. Lit Med. 2006;25(2):463–74.
Irvine CA. The other side of silence: levinas, medicine, and literature. Lit Med. 2005;24(1):8–18.
Marcus ER. Medical student dreams about medical school: the unconscious developmental process of becoming a physician. Int J Psychoanal. 2003;84(Pt 2):367–86.
Slade M, Sweeney A. Rethinking the concept of insight. World Psychiatry. 2020;19(3):389–90.
Stanley P. The patient’s voice: a cry in solitude or a call for community. Lit Med. 2004;23(2):346–63.
Arras JD. Getting down to cases: the revival of casuistry in bioethics. J Med Philos. 1991;16(1):29–51.
Chin NP. Telling an Ongoing Story With an Ethnographic Voice: Reflections on “Family, Ethnicity, and Chronic Disease: An Ongoing Story With a New Twist.” Fam Syst Health. 2005;23:307–11.
Fisher P, Lees J. Narrative approaches in mental health: Preserving the emancipatory tradition. Health (London). 2016;20(6):599–615.
Hydén LC, Örulv L. Narrative and identity in Alzheimer’s disease: a case study. Journal of Aging Studies. 2009;23(4):205–14.
Tappan MB. Telling moral stories: from agency to authorship commentary on Pasupathi and Wainryb. Hum Dev. 2010;53(2):81–7.
Tucker RP, Haydel R, Zielinski M, Niederkrotenthaler T. Storytelling of suicide attempt recovery and its relationship with mental health treatment-seeking attitudes and behaviors: an experimental study. J Am Coll Health. 2022;70(3):801–9.
De Vito B, Castagno E, Garrone E, Tardivo I, Conti A, Luciani M, et al. Narrating care during the COVID-19 pandemic in a paediatric emergency department. Reflective Pract. 2022;23(2):219–31.
Ofri D. The passion and the peril: storytelling in medicine. Acad Med. 2015;90(8):1005–6.
Spector-Mersel G, Knaifel E. Narrative research on mental health recovery: two sister paradigms. J Ment Health. 2018;27(4):298–306.
Stephens S. How doctors use stories to help them cope with the coronavirus crisis. LA Times. 2020 28/03/2023. Available from: https://www.latimes.com/science/story/2020-06-10/doctors-use-narrative-medicine-to-cope-with-the-coronavirus.
Colwell J. Narrative medicine seeks the story behind the illness: ACP Internist; 2020 Available from: https://acpinternist.org/archives/2020/10/narrative-medicine-seeks-the-story-behind-the-illness.htm.
Medicine P. Listening Lab: Harnessing the Power of Storytelling Penn Medicine; 2021. Available from: https://www.pennmedicine.org/news/internal-newsletters/system-news/2021/may/listening-lab-harnessing-the-power-of-storytelling.
Bajaj N, Phelan J, McConnell EE, Reed SM. A narrative medicine intervention in pediatric residents led to sustained improvements in resident well-being. Ann Med. 2023;55(1):849–59.
Alderson TS, Bateman H. Doctors telling stories: the place of anecdote in GP registrar training. Med Teach. 2002;24(6):654–7.
Moran GS, Russinova Z, Gidugu V, Yim JY, Sprague C. Benefits and mechanisms of recovery among peer providers with psychiatric illnesses. Qual Health Res. 2012;22(3):304–19.
Oakley S, Grealish L, Coyne E. Telling their story: a qualitative descriptive study of the lived experience of expatriate palliative care nurses in the United Arab Emirates. Eur J Oncol Nurs. 2020;48:101793.
Truong C, Gallo J, Roter D, Joo J. The role of self-disclosure by peer mentors: Using personal narratives in depression care. Patient Educ Couns. 2019;102(7):1273–9.
Wimberly EP. Story telling and managing trauma: health and spirituality at work. J Health Care Poor Underserved. 2011;22(3 Suppl):48–57.
Williams A, Fossey E, Farhall J, Foley F, Thomas N. Recovery after psychosis: qualitative study of service user experiences of lived experience videos on a recovery-oriented website. JMIR Ment Health. 2018;5(2): e37.
Abdel-Aziz S, Galal YS, Al Hanafy SH, Ghamrawy M, Mohamed Shaheen DS. Digital storytelling: a video-based approach for engaging university students in health education. Open Access Macedonian J Med Sci. 2022;10(E):33–9.
Adelman RD, Greene MG, Charon R. The physician-elderly patient-companion triad in the medical encounter: the development of a conceptual framework and research agenda. Gerontologist. 1987;27(6):729–34.
Bruno R, Andrews A, Garvey B, Huntoon K, Mazumder R, Olson J, et al. Videotaped patient stories: impact on medical students’ attitudes regarding healthcare for the uninsured and underinsured. PLoS One. 2012;7(12):e51827.
Charon R. To render the lives of patients. Lit Med. 1986;5:58–74.
Cueva M, Kuhnley R, Revels LJ, Cueva K, Dignan M, Lanier AP. Bridging storytelling traditions with digital technology. Int J Circumpolar Health. 2013;72(1):20717.
Kempson D, Murdock V. Memory keepers: a narrative study on siblings never known. Death Stud. 2010;34(8):738–56.
Kerr DJR, Deane FP, Crowe TP. A complexity perspective on narrative identity reconstruction in mental health recovery. Qual Health Res. 2020;30(4):634–49.
Leeder S. Telling the story of mental health. Med J Aust. 2015;202(4):161.
Llewellyn-Beardsley J, Rennick-Egglestone S, Callard F, Crawford P, Farkas M, Hui A, et al. Characteristics of mental health recovery narratives: systematic review and narrative synthesis. PLoS One. 2019;14(3):e0214678.
Mancini MA. Strategic storytelling: an exploration of the professional practices of mental health peer providers. Qual Health Res. 2019;29(9):1266–76.
Moreau KA, Eady K, Sikora L, Horsley T. Digital storytelling in health professions education: a systematic review. BMC Med Educ. 2018;18(1):208.
Rennick-Egglestone S, Ramsay A, McGranahan R, Llewellyn-Beardsley J, Hui A, Pollock K, et al. The impact of mental health recovery narratives on recipients experiencing mental health problems: Qualitative analysis and change model. PLoS One. 2019;14(12):e0226201.
Simons SS. ER Goddess: storytelling, advocacy, and being authentic. Emerg Med News. 2018;40(1):19.
Sisson G, Kimport K. Telling stories about abortion: abortion-related plots in American film and television, 1916–2013. Contraception. 2014;89(5):413–8.
Sabaretnam M, Bothra S, Warsi D. The technique of story-telling in thyroid diseases including surgery; useful or not. Ann Med Surg. 2019;41:43–6.
Avrahami E. Positive wrongdoings: reading doctors’ narratives on ordinary ethics. Lit Med. 2011;29(2):325–54.
Flagler E. Narrative ethics: a means to enrich medical education. Ann R Coll Physicians Surg Can. 1997;30(4):217–20.
Hoffmaster B. From applied ethics to narrative ethics: the rationality and morality of telling stories in bioethics. Hastings Cent Rep. 2014;44(3):4–6.
Ross JW. Literature, bioethics, and the priestly physician. Hastings Cent Rep. 1994;24(3):25–6.
Zaner RM. On evoking clinical meaning. J Med Philos. 2006;31(6):655–66.
Brody H. “My story is broken; can you help me fix it?” Medical ethics and the joint construction of narrative. Lit Med. 1994;13(1):79–92.
Charon R. Narrative medicine: form, function, and ethics. Ann Intern Med. 2001;134(1):83–7.
Charon R. What narrative competence is for. Am J Bioeth. 2001;1(1):62–3.
Charon R, Brody H, Clark MW, Davis D, Martinez R, Nelson RM. Literature and ethical medicine: five cases from common practice. J Med Philos. 1996;21(3):243–65.
Halil T. Ethical Considerations Related to Narrative Medicine. In: Omur S, editor. Patient Centered Medicine. Rijeka: IntechOpen; 2017. p. Ch. 8.
Hewson J, Danbrook C, Sieppert J. Engaging post-secondary students and older adults in an intergenerational digital storytelling course. Contemp Issues Educ Res. 2015;8(3):135–42.
Stacy R, Spencer J. Patients as teachers: a qualitative study of patients’ views on their role in a community-based undergraduate project. Med Educ. 1999;33(9):688–94.
Walsh CA, Shier ML, Sitter KC, Sieppert JD. Applied methods of teaching about oppression and diversity to graduate social work students: a case example of digital stories. Can J Scholarship Teach Learn. 2010;1(2):3.
ClinCaseQuest. Storytelling in medical education: ClinCaseQuest. Available from: https://clincasequest.hospital/case-method/.
Thibodeau PH, Boroditsky L. Metaphors we think with: the role of metaphor in reasoning. PLoS One. 2011;6(2):e16782.
Versalovic E. Baylor Narrative Medicine's ‘Off Script’ storytelling hour 2016. Available from: https://blogs.bcm.edu/2016/06/28/baylor-narrative-medicines-off-script-storytelling-hour/.
Zitter J. How Storytelling Can Help Young Doctors Become More Resilient Harvard Business Review; 2018. Available from: https://hbr.org/2018/10/how-storytelling-can-help-young-doctors-become-more-resilient.
Charon R. A Momentary watcher, or the imperiled reader of “a round of visits” The Henry James Review. 2008;29(3):275–86.
Charon R, Hermann N. Commentary: a sense of story, or why teach reflective writing? Acad Med. 2012;87(1):5–7.
Charon R. Narrative reciprocity. Hastings Cent Rep. 2014;44(s1):S21–4.
Lim JY, Ong SYK, Ng CYH, Chan KLE, Wu SYEA, So WZ, et al. A systematic scoping review of reflective writing in medical education. BMC Med Educ. 2023;23(1):12.
Cueva M, Kuhnley R, Lanier A, Dignan M, Revels L, Schoenberg NE, et al. Promoting culturally respectful cancer education through digital storytelling. Int J Indig Health. 2016;11(1):34–49.
Fins JJ. Two patients: professional formation before “Narrative Medicine.” Camb Q Healthc Ethics. 2020;29(4):642–50.
Sibbald B. A clearing for narrative practice. CMAJ. 2016;188(17–18):1267–8.
Charon R. Commentary: calculating the contributions of humanities to medical practice-motives, methods, and metrics. Acad Med. 2010;85(6):935–7.
Charon R. Medicine, the novel, and the passage of time. Ann Intern Med. 2000;132(1):63–8.
Charon R. The seasons of the patient-physician relationship. Clin Geriatr Med. 2000;16(1):37–50.
Hurwitz B, Charon R. A narrative future for health care. Lancet. 2013;381(9881):1886–7.
Warmington S, McColl G. Medical student stories of participation in patient care-related activities: the construction of relational identity. Adv Health Sci Educ Theory Pract. 2017;22(1):147–63.
Hanna M, Fins JJ. Viewpoint: power and communication: why simulation training ought to be complemented by experiential and humanist learning. Acad Med. 2006;81(3):265–70.
Campbell J. The hero with a thousand faces. 3rd ed. Novato, Calif: New World Library; 2008.
Kathy. Healthcare Storytelling: The Best Marketing Magic and How to Do It. Available from: https://healthcaresuccess.com/blog/healthcare-marketing/healthcare-storytelling-marketing-magic.html.
Cabrera D. From Odysseus to Yoda. Storytelling in medical education 2016. Available from: https://icenetblog.royalcollege.ca/2016/05/03/from-odysseus-to-yoda-storytelling-in-medical-education/.
Frank AW. The Wounded Storyteller: Body, Illness, and Ethics. Second ed: University of Chicago Press; 2013.
Gu Y. Narrative, life writing, and healing: the therapeutic functions of storytelling. Neohelicon. 2018;45(2):479–89.
Sandars J. The use of reflection in medical education: AMEE Guide No. 44. Med Teach. 2009;31(8):685–95.
Carmack HJ. Bearing witness to the ethics of practice: storying physicians’ medical mistake narratives. Health Commun. 2010;25(5):449–58.
Paton A, Kotzee B. The fundamental role of storytelling and practical wisdom in facilitating the ethics education of junior doctors. Health (London). 2021;25(4):417–33.
Chang MK, Lim MX, Tay K, Lee RJ, Sim DSW, Menon S, et al. The influence of evolving confucian beliefs in the selection of proxy decision-makers at the end of life in Singapore. Asian Bioethics Review. 2017;9(1):117–28.
Krishna L. Palliative care imperative: a framework for holistic and inclusive palliative care. Ethics Med. 2013;29:41–61.
Krishna L. The position of the family of palliative care patients within the decision-making process at the end of life in Singapore. Ethics Med Int J Bioethics. 2011;27:183.
Krishna LKR, Alsuwaigh R, Miti PT, Wei SS, Ling KH, Manoharan D. The influence of the family in conceptions of personhood in the palliative care setting in Singapore and its influence upon decision making. Am J Hospice Palliat Med. 2014;31(6):645–54.
Ho ZJM, Krishna L, Goh C, Yee A. The physician-patient relationship in treatment decision making at the end of life: a pilot study of cancer patients in a Southeast Asian society. Palliat Support Care. 2012;11:1–7.
Tay KT, Tan XH, Tan LHE, Vythilingam D, Chin AMC, Loh V, et al. A systematic scoping review and thematic analysis of interprofessional mentoring in medicine from 2000 to 2019. J Interprof Care. 2021;35(6):927–39.
Khurshid Z, McAuliffe E, De Brún A. Exploring healthcare staff narratives to understand the role of quality improvement methods in innovative practices during COVID-19. BMC Health Serv Res. 2021;21(1):1271.
Grob R, Schlesinger M, Barre LR, Bardach N, Lagu T, Shaller D, et al. What words convey: the potential for patient narratives to inform quality improvement. Milbank Q. 2019;97(1):176–227.
Chu S-Y, Wen C-C, Lin C-W. A qualitative study of clinical narrative competence of medical personnel. BMC Med Educ. 2020;20(1):415.
Sinclair HA, Hamill C. Does vicarious traumatisation affect oncology nurses? A literature review. Eur J Oncol Nurs. 2007;11(4):348–56.
Ho ZJM, Krishna L, Yee A. Chinese familial tradition and western influence: a case study in singapore on decision making at the end of life. J Pain Symptom Manage. 2010;40:932–7.
Foo W, Zheng Y, Kwee A, Yang G, Krishna L. Factors considered in end-of-life care decision making by health care professionals. Am J Hosp Palliative Care. 2012;30(4):354–8.
Chong J, Quah Y, Yang G, Menon S, Krishna L. Patient and family involvement in decision making for management of cancer patients at a centre in Singapore. BMJ Support Palliat Care. 2013;5(4):420–6.
Chai HZ, Krishna L, Wong V. Feeding: what it means to patients and caregivers and how these views influence Singaporean Chinese caregivers’ decisions to continue feeding at the end of life. Am J Hosp Palliat Care. 2013;31(2):166–71.
Acknowledgements
The authors would like to dedicate this paper to the late Dr. S Radha Krishna and A/Prof Cynthia Goh whose advice and ideas were integral to the success of this review and Thondy, Maia Olivia and Raja Kamarul whose lives continue to inspire us. The authors would also like to thank the anonymous reviewers, Ms. Annelissa Mien Chew Chin, Dr Ruaraidh Hill and Dr Stephen Mason for their helpful comments which greatly enhanced this manuscript.
Funding
No funding was received for this review.
Author information
Authors and Affiliations
Contributions
All the authors, ELYQ, KZYC, CKRL, AVV, NABAH, JLJO, NS, NW, CL, GLGP, EKO, WF, LKRK were involved in data curation, formal analysis, investigation, and preparation of the original draft of the manuscript, as well as reviewing and editing the manuscript. All aforementioned authors have read and approved the manuscript.
Corresponding author
Ethics declarations
Ethics approval and consent to participate
NA.
Consent for publication
NA.
Competing interests
The authors declare no competing interests.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Supplementary Information
Additional file 1.
Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Checklist.
Additional file 2.
Search Strategies.
Additional file 3.
Study Characteristics of Included Articles.
Rights and permissions
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
About this article
Cite this article
Quah, E.L.Y., Chua, K.Z.Y., Lin, C.K.R. et al. The role of patients’ stories in medicine: a systematic scoping review. BMC Palliat Care 22, 199 (2023). https://doi.org/10.1186/s12904-023-01319-w
Received:
Accepted:
Published:
DOI: https://doi.org/10.1186/s12904-023-01319-w