Aim: An exploratory, qualitative study examining the attitudes of gastroenterologists, patients, and medical students regarding the use of patients' expressive writings about IBS in the outpatient setting. Methods: IBS patients (P), Gastroenterologists (GI) and Medical students (MS) from a single academic institution (BU) were asked to read three representative IBS expressive writings selected by the authors from a previous study. All participants were interviewed regarding the utility and feasibility of using the writings in an outpatient clinical setting. All responses were recorded verbatim and qualitatively analyzed by the authors. Results: 10/10 GI (8 attending, 2 fellows), 10/14 P and 10/13 MS agreed to participate. GI: age (mean ± SD) 39.2 ± 7.7, M 80 %, y of practicing 7 ± 12.4, average # of IBS patients/ week 8.5 ± 7.2: MS: age 24.6 ± 2.0, M 40%, y of med. school 1.7 ± 1.10; P: age 43.3 ± 15.2, M 30%, y with IBS 15 ± 16, number of visits for IBS / 12 months 2.7 ± 2.9. The length of the writings was a 1/2 typed page (range: 1/2 3/4 typed page), interview time 15.4 ± 5.5 minutes. The actual time needed to read one writing was (1.7 min ± 0.5) vs. perceived time (2.8 min ± 1.1). 9/10 patients expressed interest in writing in the future. Although 7/10 of GI reported not learning anything surprising from the writings, 9/10 GI were interested in using them in clinical practice. 10/10 P felt that home is the best setting for writing, while GI favored the waiting room over home in order to limit length of writing. MS first response to writing was more empathic than that of the GI. The main themes identified during the interviews are outlined in Table 1. Conclusion: Our results indicate that gastroenterologists, medical students, and patients are very receptive to using IBS expressive writing in the outpatient setting and find it a useful tool in obtaining clinical information as well as helpful in promoting empathic physician patient relationships. A follow-up trial will study the effects of using this modality in outpatient setting on IBS clinical outcomes. Further implications include the use of patients' writings for medical training. TABLE 1
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