Narrative Interviewing in Clinical Settings

Session outline

Narratives enrich our understanding of the patients’ experience of illness through first-hand descriptions of care received. The patient as storyteller¹ underlies a central component of narrative medicine and the way these stories are elicited lies at the core of this workshop.  The narrative (or qualitative) interview is distinguished from the common clinical interview.  The narrative interview is loosely structured with few preconceived assumptions while the clinical interview is structured in a biomedical framework.   The narrative interview strives to illicit the experience of the patient and gain insight into the meaning and significance of the health issues.  Active listening is a key component of the narrative interview. The clinical interview builds from a medical-scientific framework to reveal an objective understanding of the condition.  In the usual clinical discussion, the discussion is more of a Q and A exchange while the narrative interview is open-ended and less structured. Both styles reveal truths about health, healthcare, and what it is like to be a patient.  The styles are complementary as each one provides insights to the other.   

This workshop teaches narrative interview skills and promotes the development of narrative competence.  After a brief orientation to patient narratives and narrative medicine, examples of narrative interviewing and the resulting stories told by patients are presented to demonstrate methods and insights gained from such interactions.    Participants will learn the skills of narrative interviews through interactive sessions and follow-up discussions with participants and faculty.  During breakout sessions, attendees role-play clinical scenarios featuring patients, providers, and healthcare trainees and then evaluate the exchanges.  Workshop participants develop a framework for narrative interviews^2,3 and learn the distinctions between narrative and usual clinical discussions.   Emphasis is placed on how insights from patient narratives can inform and improve work in clinical settings including clinical services and trainee education.

References

1. Lamprell, Klay & Braithwaite, Jeffrey (2016). Patients as story-tellers of healthcare journeys. Medical Humanities 42 (3):207-209. doi: 10.1136/medhum-2016-010885
2. Illness narratives in the workplace In: Lucius-Hoene, Gabriele, Holmberg, Christine & Meyer, Thorsten (eds.) Illness Narratives in Practice – Potentials ans Challenges. (p. 115-127). Oxford: Oxford University Press; DO  – 10.1093/med/9780198806660.003.0010
3. See DIPEx (https://dipexinternational.org/)

Learning outcomes

Primary Goal – Demonstrate narrative interviewing techniques that could be integrated into clinical settings.

Objectives –

• Familiarize attendees with narrative medicine and qualitative interviewing (narrative knowledge).
• Distinguish narrative and clinical interviewing techniques in terms of style and purpose. 
• Demonstrate narrative interviewing techniques (narrative competence).
• Discuss the use of narrative strategies in clinical settings.

Target audience

• Allied health
• Medical practitioners
• Students
• Trainees
• Nursing staff
• General public 

 The material and approach are primarily targeting medical practitioners, students, and trainees.