Narrative techniques in clinical research, education and therapy

There is a recognition in contemporary healthcare education that it is not enough merely to have the relevant clinical knowledge and clinical skills.  Health professionals must have excellent professional attitudes.  An understanding of the Humanities can offer clinical students and health professionals another way of thinking about and talking about the world, and can help them to understand it.  There is increasing evidence also that the Humanities can have a therapeutic effect on those suffering from illness.

There is in fact a great deal of interest at present in Medical Humanities, with established centres in UK (eg Durham) and the US (eg New York University).  At Birmingham there is a long tradition within the College of MDS of learning and teaching in these areas (eg Skelton Lancet 2000a and 2000b): undergraduate Medical Students have had the opportunity to study aspects of the humanities for 15 years as part of the MBChB Programme.

Colleagues in MDS, have looked specifically at the issue of medical narratives, following through a developing tradition in the US (eg Charon 2006) and UK (Hurwitz, Greenhalgh, Skultans 2008. See also Skelton “Narrative Medicine” in Kirkcaldy B, ed.  Art and Science of Medicine 2011).  The interest has been in the nature of literary narrative applied to a healthcare context (Skelton Language and clinical communication 2008) and in the use of narrative as a research methodology (O ’Riordan, Skelton, de la Croix Family Practice 2008). 

Polly Wright, Interactive Studies Unit in MDS, has worked with colleagues in Psychiatry to give medical students from Birmingham – on a volunteer basis, a training in her version of what is known as Reading for Well-being.  This involves our students reading literary texts to patients with mental ill-health, and then discussing with them how the reading is relevant to their lives. This in turn builds on her work with Birmingham and Solihull Mental Health Foundation Trust, for whom she trained 70 NHS staff in the method.  We are preparing a bid to go to Wellcome, though this will be some months in the future.

Possible participants

Polly Wright, MDS

Giles Berrisford (Consultant Psychiatrist, Barberry Centre, Birmingham)

Margaret O’Riordan, Irish College of General Practice

Anne de la Croix, Erasmus University, Rotterdam

Brian Hurwitz, King’s London.http://www.kcl.ac.uk/artshums/depts/english/people/staff/academic/hurwitz/index.aspx )

This offers an opportunity for genuinely cross-disciplinary work.  In addition, the research tradition in narrative medicine has had virtually nothing to say on linguistic aspects.  Through Skelton and Shanks (Skelton, series of papers from 1999: Shanks in press), there is scope for an original contribution.  Polly Wright’s approach to the delivery of reading for therapy is also original, as is the use – just being launched – of narrative work to support medical students and doctors in need of remedial support.

Possible workshop structure

1. Introduction: what humanities can add to science – “evidence” and “knowledge”
2. Narratives as a research technique (based on O’Riordan et al, loc cit)
3. Narratives as teaching (based on the experience of teaching students to appreciate and interpret narratives in literature, and on using literature as remedial support for medical students and doctors)
4. Narratives as therapy (based on Wright’s project with mental health service users and medical students).