Abstract
Narrative writing has been used to promote reflection and increased self-awareness among physicians. The purpose of this study was to determine the impact of prompted narrative writing on reflection. Thirty-two interns at 9 internal medicine residency programs participated in a year-long qualitative study about personal growth beginning in July of 2002. Interns wrote narratives every 8 weeks. At study completion, interns wrote a final narrative describing the affect that being in the study had on them. Responses were reviewed and organized into domains. Writing throughout the year resulted in reflection and encouraged interns to reconsider their core values and priorities. Some found that the exercise promoted greater self-awareness and provided an emotional outlet. Writing about difficult experiences coupled with reflection motivated some interns to want to improve. Prompted narrative writing led to reflection among interns and promoted self-awareness. Educators may consider incorporating narrative writing into residency education.
Similar content being viewed by others
References
Bolton, G. (2001). Reflective practice: Writing and professional development. London: Paul Chapman Publishing Ltd.
Boud, E. M., Keough, R., & Walker, D. (1985). Reflection: Turning experience into learning. London: Kogan Page.
Brady, D. W., Corbie-Smith, G., & Branch, W. T. (2002). “What’s important to you?” The use of narratives to promote self-reflection and to understand the experiences of medical residents. Annals of Internal Medicine, 137(3), 220–223.
Branch, W. T., & Paranjape, A. (2002). Feedback and reflection: Teaching methods for clinical settings. Academic Medicine, 77(12, part 1), 1185–1188.
Branch, W. T., Jr., Kern, D., Haidet, P., Weissmann, P., Gracey, C. F., Mitchell, G., et al. (2001). The patient–physician relationship. Teaching the human dimensions of care in clinical settings. Journal of the American Medical Association, 286(9), 1067–1074.
Branch, W. T., & Suchman, A. (1990). Meaningful experiences in medicine. American Journal of Medicine, 88(1), 56–59.
Charon, R. (2001). The patient–physician relationship. Narrative medicine: A model for empathy, reflection, profession, and trust. Journal of the American Medical Association, 286(15), 1897–1902.
Charon, R. (2001). Narrative medicine: Form, function, and ethics. Annals of Internal Medicine, 134(1), 83–87.
DasGupta, S., & Charon, R. (2004). Personal illness narratives: Using reflective writing to teach empathy. Academic Medicine, 79(4), 351–356.
Epstein, R. M. (1999). Mindful practice. Journal of the American Medical Association, 282(9), 833–839.
Epstein, R. M, & Hundert, E. (2002). Defining and assessing professional competence. Journal of the American Medical Association, 287(2), 226–235.
Gaver, A., Borkan, J. M., & Weingarten, M. A. (2005). Illness in context and families as teachers: A year long project for medical students. Academic Medicine, 80(5), 448–451.
Ghaye, T. (2007). Is reflective practice ethical? (The case of the reflective portfolio). Reflective Practice, 8(2), 151–162.
Horowitz, C. R., Suchman, A. L., Branch, W. T., Jr., & Frankel, R. M. (2003). What do doctors find meaningful about their work? Annals of Internal Medicine, 138(9), 772–775.
Kern, D. E., Wright, S. M., Carrese, J. A., Lipkin, M., Jr., Simmons, J. M., Novack, D. H., et al. (2001). Personal growth in medical faculty: A qualitative study. Western Journal of Medicine, 175(2), 92–98.
Kolb, D. (1984). Experiential learning. Englewood Cliffs: Prentice Hill.
Levine, R. B., Haidet, P., Kern, D. E, Beasley, B. W., Bensinger, L., Brady, D. W., Gress. T., Hughes, J., Marwaha, A., Nelson, J., & Wright, S. M. (2006). Personal growth during internship: A qualitative analysis of interns’ responses to key questions. Journal of General Internal Medicine, 21(6), 564–569.
Lincoln, Y., & Guba, E. (1985). Naturalistic inquiry. Beverly Hills: Sage.
Longhurst, M. (1988). Physician self-awareness: The neglected insight. Canadian Medical Association Journal, 139(2), 121–124.
MacLeod, R. D. (2001). On reflection: Doctors learning to care for people who are dying. Social Science and Medicine, 52(11), 1719–1727.
Mamede, S., & Schmidt, H. G. (2004). The structure of reflective practice in medicine. Medical Education, 38, 1302–1308.
Mamede, S., & Schmidt, H. G. (2005). Correlates of reflective practice in medicine. Advances in Health Sciences Education, 10, 327–337.
Meier, D. E., Back, A. L., & Morrison, R. S. (2001) The inner life of physicians and care of the seriously ill. Journal of the American Medical Association, 286(23), 3007–3014.
Miller, W. L., & Crabtree, B. F. (1992). Primary care research: A multimethod typology and qualitative road map. In B. F. Crabtree & W. L. Miller (Eds.), Doing qualiatative research (pp. 3–28). Newbury Park: Sage Publications.
Novack, D. H., Epstein, R. M., & Paulsen, R. H. (1999). Toward creating physician-healers: Fostering medical students’ self-awareness, personal growth, and well-being. Academic Medicine, 74(5), 516–520.
Novack, D. H., Suchman, A. L., Clark, W., Epstein, R. M., Najberg, E., & Kaplan, C. (1997). Calibrating the physician. Personal awareness and effective patient care. Working Group on Promoting Physician Personal Awareness, American Academy on Physician and Patient. Journal of the American Medical Association, 278(6), 502–509.
Pennebaker, J. W. (2000). Telling stories: The health benefits of narrative. Literature and Medicine, 19(1), 3–18.
Rabow, M. W., & McPhee, S. J. (2001). Doctoring to Heal: Fostering well-being among physicians through personal reflection. Western Journal of Medicine, 174(1), 66–69.
Rolfe, G. (2002). Reflective practice: Where now? Nurse Education in Practice, 2, 21–29.
Ryff, C. D., & Singer, B. (1996). Psychological well-being: Meaning, measurement and implications for psychotherapy research. Psychotherapy and Psychosomatics, 65, 14–23.
Scannell, K. (2002). Writing for our lives: Physician narratives and medical practice. Annals of Internal Medicine, 137(9), 779–781.
Schon, D. A. (1983). The reflective practitioner. London: Temple Smith.
Wright, S. M., Levine, R. B., Beasley, B., Haidet, P., Gress, T. W., Caccamese, S., Brady, D., Marwaha, A., & Kern, D. E. (2006). Personal growth and its correlates during residency training. Medical Education, 40, 737–745.
Acknowledgements
Dr. Levine is the Society of General Internal Medicine’s, Mary O’Flaherty Horn Scholar in General Internal Medicine. Dr. Wright is an Arnold P. Gold Foundation Associate Professor of Medicine and a Miller-Coulson Family Scholar.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Levine, R.B., Kern, D.E. & Wright, S.M. The impact of prompted narrative writing during internship on reflective practice: a qualitative study. Adv in Health Sci Educ 13, 723–733 (2008). https://doi.org/10.1007/s10459-007-9079-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10459-007-9079-x