Learning through narrative writing: Medical students talk to patients in a hospice

Aim: This study examined how medical students use narrative writing as a pedagogical tool to process the experience of talking with patients at end-of-life and express what they have learnt. Background:  There are a variety of ways that medical students are nd:taught about communicating with patients at end-of-life, including talking directly with patients. Method: Eighty-nine students opted to have their narrative essays retained for research after the academic year was completed. Thirty essays were chosen as representative for the dataset. Charmaz’s constructivist grounded theory methodology was adopted, with theoretical sensitivity used to test categories and theoretical concepts of emerging theory. Results: Narrative writing articulates a learning moment co-created by the medical student, teacher and dying patient. A theory of “learning through narrative” is put forward, with the categories of tension, challenge and growth being identifiable in the students’ essays. Conclusion: In this context, narrative writing, as a pedagogical tool, assists students to understand both the patient and themselves. For most students, this is a challenging experience. They integrate past experience and articulate transformational learning to teachers who in turn are able to monitor the safety of learning. Narrative writing enables students to resolve initial tension, gain insights, describe new skills as well as grow personally and professionally.