Narrative nephrology via clinical scenario-based workshop promotes empathy in medical students

Abstract

Abstract Background: The practice of nephrology demands empathy. The aim of this study was to test the feasibility and effectiveness of providing a narrative training (NT) program for the purpose of promoting empathy. Methods: The program, including six weekly 1-hour sessions of narrative workshops, was conducted in medical interns in Second Affiliated Hospital of Zhejiang University School of Medicine. During each session, participants encountered a representative clinical scenario. Participants wrote about their attachment and emotional responses to patients, and their attempts to imagine clinical situations from the perspectives of patients and family members. Participants then shared their pieces in a facilitated discussion. This study employed a pre- and post-intervention design and was also supplemented with a separate control of peers who participated in the traditional teaching activities. Participants were surveyed using modified Jefferson Scale of Physician Empathy (JSPE) before and after the interventions. Results: Eighteen interns who consented and participated in the program completed all baseline and post-intervention measures. The change in JSPE scores from baseline to post-intervention was significantly higher in NT group than control group (p=0.0014, t=3.868). The subsets of Perspective Taking (p=0.00178, t=2.640) and Compassionate Care (p<0.0001, t=5.395) improved at a statistically significant level, and the Standing in patient’s shoes subset trended toward significant improvement (p=0.2895, t=1.093). The participants in workshops considered beneficial for empathy, professionalism and holistic care, and showed enthusiasm in further narrative training. Conclusions: Clinical scenario-based narrative training was feasible and well-received by students and improved students’ empathy in this short run. Larger studies are required to validate its long-term effects on behavior changes, organizational practice and benefits to patients.