Background

Based on the principles of Narrative Medicine, this study explored a narrative-based workshop for multi-level interdisciplinary clinicians who have EOL conversations.

Methods

Fifty-two clinicians participated in narrative-based interactive workshops. Participants engaged narrative in three forms: viewing narratives, writing/sharing narratives, and co-constructing narratives. Post workshop interviews were conducted and thematically analyzed.

Results

Five themes characterized how the workshop shaped learning and subsequent care experiences: (1) learning to enter/respond to the patient stories, (2) communicating across professions and disciplines, (3) practicing self-care. Additional themes emphasized (4) barriers to narrative learning and (5) obstacles to applying narrative to practice.

Discussion

Results highlight the function/utility of narrative forms such as the value of processing emotions via reflective writing, feeling vulnerable while sharing narratives, and appreciating colleagues’ obstacles while observing patient-clinician simulations. Challenges associated with narrative such as writing anxiety and barriers to implementation such as time constraints are detailed to inform future initiatives.

中文翻译：

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试行基于跨专业叙事的临终对话互动研讨会：对学习和实践的启示

背景

基于叙事医学的原则，本研究为进行 EOL 对话的多层次跨学科临床医生探索了一个基于叙事的研讨会。

方法

五十二名临床医生参加了基于叙述的互动研讨会。参与者以三种形式参与叙事：观看叙事、撰写/分享叙事和共同构建叙事。进行了研讨会后访谈并进行了主题分析。

结果

五个主题描述了研讨会如何塑造学习和随后的护理体验：(1) 学习输入/回应患者的故事，(2) 跨专业和学科的交流，(3) 实践自我护理。其他主题强调 (4) 叙事学习的障碍和 (5) 将叙事应用于实践的障碍。

讨论

结果突出了叙事形式的功能/效用，例如通过反思性写作处理情绪的价值，在分享叙事时感到脆弱，以及在观察患者-临床医生模拟时理解同事的障碍。与叙述相关的挑战（例如写作焦虑）和实施障碍（例如时间限制）被详细说明以告知未来的举措。