The Use of Narrative in Medical Education.

A course was designed for medical students in which literature and writing exercises were used to promote reflection on cross-cultural patient encounters. Students were encouraged to consider Kleinman’s principles of open-ended questioning as the basis for enhancing these patient conversations and were prompted to develop skills in close reading of texts, specifically recognition of the reader’s response to narrative, understanding of point of view, and recognition of the impulse to create story, or plot. Transcriptions of class discussion and material from written essays were used to inform the instructor’s understanding of learners’ progress. This study may offer a new conceptual lens for viewing ways in which cultural competency and other features of physician-patient communication may be taught using narrative skill training. When anchored to exercises in reflective writing, student learners develop a framework with which to view and interpret their patient stories.