Navigating uncertainty: Narrative medicine in pregnancy options counseling education

Abstract

ObjectivesPregnancy options counseling, or nondirective counseling of patients with unintended pregnancy, is a “necessary competency” for medical students according the Association of Professors of Gynecology and Obstetrics. Narrative Medicine (NM) utilizes stories of illness to inform clinical practice and promotes self-reflection in medical education. The authors analyzed the effect of a NM workshop on medical students’ ability to provide pregnancy options counseling. MethodsThe authors randomized students in the major clinical year at Columbia University Medical Center (CUMC) to either a 2-hour NM workshop or to a control intervention. The NM group participated in reading and reflective writing exercises addressing varying perspectives on pregnancy. Students then completed a video-taped and numerically-scored OSCE (Objective Structured Clinical Examination) regarding pregnancy options counseling. The authors compared mean OSCE scores between the groups. ResultsThe study analyzed 103 participants. Overall mean OSCE scores were higher in the NM group (11.9 ± 1.5, n = 51) than the control group (11.3 ± 1.6, n = 52) (p = 0.049). ConclusionsStudents undergoing a NM workshop had higher scores on a pregnancy options counseling OSCE. Practice implicationsThis brief intervention may aid future physicians in providing nondirective pregnancy options. This novel approach to teaching is an easily shared learning tool.