Using narrative medicine in options counseling education: A randomized controlled trial

Awarded 2014
Complex Family Planning Fellowship Research
Katherine Rivlin, MD
Columbia University

Medical students can carry strong preexisting personal beliefs about pregnancy options through their training. Medical school curricula often do not allow students the opportunity to understand these complex beliefs.  Narrative Medicine (NM), the practice of engaging with illness through artistic dimensions, can be used to address the “difficult to teach” clinical competencies such as empathy, patient centered care and communication. We used NM to teach pregnancy options counseling to students.
Our primary objective was to assess the impact of a NM workshop on medical students’ ability to provide nonjudgmental and nondirective pregnancy options counseling. We hypothesized that participating in a NM workshop would improve student scores on an Options Counseling objective structured clinical examination, or OSCE.
We randomized  students at Columbia University Medical Center (CUMC) to a NM workshop or to a control intervention. Students in the NM group participated in reading and reflective writing that addressed varying perspectives on pregnancy. Students in the control group participated in a session on another Ob-Gyn topic. All students received the ANSIRH curriculum on pregnancy options counseling. At the end of the rotation, all students completed a numerically scored OSCE on pregnancy options counseling.
We compared mean OSCE scores between the NM group and the control group for our primary analysis.