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Background <p>Effective communication is a fundamental skill in clinical medicine; however, traditional approaches often fail to equip learners with an ability to authentically and empathically engage with the complexities of real patients’ experiences. Narratology has been proposed as a pedagogical framework for augmenting empathy and patient-centred communication in medical students.</p> Methods <p>In April 2025, we undertook a mixed-methods pilot study to evaluate the impact of a one-week narratology module on second-year undergraduate medical students at the Royal College of Surgeons in Ireland (RCSI), Dublin. The module involved close reading, group viewings, facilitated small-group workshops, and whole-group discussions in response to narrative works by Irish writers and storytellers, followed by written personal reflections. At the outset and conclusion of the module, each student undertook a clinical history with a simulated patient (SP) portraying early-stage dementia. SPs assessed each student’s empathy and communication using the Consultation and Relational Empathy (CARE) Measure.</p> Results <p>Overall, 30 medical students (age 20 ± 1.1 yrs, 59.1% female) were included; of these, 22 completed both SP encounters. Total CARE Measure score significantly increased post-intervention: median within-subject difference = 3.00 (-0.25, 10.00) [<i>P</i> = 0.0035]. Analysis of individual CARE Measure items revealed significant improvement post-intervention in “Q2: Letting you tell your story” (<i>P</i> = 0.0131), “Q3: Really listening” (<i>P</i> = 0.0474), “Q4: Being interested in you as a whole person” (<i>P</i> = 0.0474), “Q5: Fully understanding your concerns” (<i>P</i> = 0.0369), and “Q6: Showing care and compassion” (<i>P</i> = 0.0054). Qualitative analysis of students’ written reflections (<i>n</i> = 30) identified three themes: (i) developing a safe and respectful communication environment; (ii) recognising the patient as a whole individual; and, (iii) growing in empathy and emotional connection.</p> Conclusion <p>Our results show that empathy and communication in early-stage medical students can improve following a short narratology module. Further prospective studies are now required to explore the longer-term effects of narratology on patient-centred healthcare.</p> Trial registration <p>ClinicalTrials.gov Identifier: NCT07084077 (Retrospective registration).</p>

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Investigating the effects of a short narratology module on empathy and patient-centred communication in early-stage medical students: an empirical mixed-methods pilot study

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  • 出版模式：

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  • 发表日期：

    2025年12月2日

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  • Bandar Alhaidari,
  • Claire Mulhall,
  • Claire Condron,
  • Jonathan Shpigelman,
  • Divyanshu Jain,
  • Michael J. Daly

摘要

Background

Effective communication is a fundamental skill in clinical medicine; however, traditional approaches often fail to equip learners with an ability to authentically and empathically engage with the complexities of real patients’ experiences. Narratology has been proposed as a pedagogical framework for augmenting empathy and patient-centred communication in medical students.

Methods

In April 2025, we undertook a mixed-methods pilot study to evaluate the impact of a one-week narratology module on second-year undergraduate medical students at the Royal College of Surgeons in Ireland (RCSI), Dublin. The module involved close reading, group viewings, facilitated small-group workshops, and whole-group discussions in response to narrative works by Irish writers and storytellers, followed by written personal reflections. At the outset and conclusion of the module, each student undertook a clinical history with a simulated patient (SP) portraying early-stage dementia. SPs assessed each student’s empathy and communication using the Consultation and Relational Empathy (CARE) Measure.

Results

Overall, 30 medical students (age 20 ± 1.1 yrs, 59.1% female) were included; of these, 22 completed both SP encounters. Total CARE Measure score significantly increased post-intervention: median within-subject difference = 3.00 (-0.25, 10.00) [P = 0.0035]. Analysis of individual CARE Measure items revealed significant improvement post-intervention in “Q2: Letting you tell your story” (P = 0.0131), “Q3: Really listening” (P = 0.0474), “Q4: Being interested in you as a whole person” (P = 0.0474), “Q5: Fully understanding your concerns” (P = 0.0369), and “Q6: Showing care and compassion” (P = 0.0054). Qualitative analysis of students’ written reflections (n = 30) identified three themes: (i) developing a safe and respectful communication environment; (ii) recognising the patient as a whole individual; and, (iii) growing in empathy and emotional connection.

Conclusion

Our results show that empathy and communication in early-stage medical students can improve following a short narratology module. Further prospective studies are now required to explore the longer-term effects of narratology on patient-centred healthcare.

Trial registration

ClinicalTrials.gov Identifier: NCT07084077 (Retrospective registration).