Narrative Competence Research Articles

Narrative medicine: Re-engaging and re-energizing ourselves through story.

Physicians and other allied health professionals have many distractions from their work and from original motivations to become health caring professionals. Activities that detract from making meaningful connection with patients result in high levels of work dissatisfaction and burnout even at early stages of career or training. Narrative Medicine provides an antidote to these influences. It is an experiential discipline that draws on the Arts and Humanities, connects health professionals to their original motivation to care, cultivates the ability to engage patients and stimulates professional growth. When practiced with interdisciplinary teams, commonalities and mutual purpose are highlighted, promoting group cohesion and appreciation. The practice of this discipline and development of narrative competence relates closely to the advancement along numerous milestones, particularly Patient Care, Interpersonal and Communication Skills, and Professionalism. This article describes an experiential and didactic workshop presented at the 2019 Forum for Behavioral Science in Family Medicine which outlined a Narrative Medicine curriculum as taught at a community hospital Family Medicine residency. The curriculum is aimed at promoting residents' professional development, personal wellbeing, and capacity to engage patients.

Multilingual Assessment Instrument for Narratives (MAIN) adapted for use in Dutch


 
 
 This contribution provides an overview of the current state of affairs with respect to the Dutch version of the Multilingual Assessment Instrument for Narratives (MAIN). We describe properties of the Dutch MAIN, the creation of the Dutch MAIN, and the results of recent research with this new instrument to measure narrative competence.
 
 

Dalla competenza sintattica alla competenza testuale: le narrazioni dei bambini italofoni dai 4 ai 10 anni

The paper investigates the way Italian children of different ages manage syntactic and narrative competence in Italian L1. The data were elicited by the story Frog, where are you? , created in 1969 by Mercer Meyer and extensively used in several L1 and L2 studies. The study aims at identifying the cognitive prerequisites on which linguistic development is founded at the ages investigated (4, 7 and 10) together with the language specific influence that Italian may have on the way children conceptualize and express information throughout a narrative text. Some crosslinguistic questions are finally considered in order to compare our results with those concerning languages other than Italian.

Historical consciousness matters: national identity, historical thinking and the struggle for a democratic education in Taiwan

ABSTRACT While Western and established democracies are wary of teaching students about national identities and aspire to broaden the framework of history education, the Republic of China (Taiwan) is still struggling to construct a Taiwanese identity to safeguard its freedom from the Chinese historical narrative. As the divide between Taiwan and China grew, what would be Taiwan’s preservice teachers’ historical consciousness and purpose of teaching history? Thirty-three preservice history teachers from Teacher Education institutions in different areas of Taiwan were interviewed in order to determine the historical consciousness of their national identity and teaching orientation. The results showed that most preservice teachers have a Taiwanese-oriented historical consciousness, while fewer of them have a mixed or Chinese orientation. Their preferred goals, thinking skills, and contents varied according to their specific historical consciousness. However, pedagogically, most of them believed that they should remain neutral on the issue of national identity. This paper argues that preservice teachers’ historical consciousness matters and teacher educators must help to clarify and develop their ‘narrative competence’ and be aware of how it orients their teaching of history; history education should be based on developing a sound democratic society, in which memories, thinking skills, and future visions come together.

L'Analista e l'analizzando come "cittadini del mondo"

Partendo dalle riflessioni di Jung sull'individuazione, l'articolo esamina la relazione analitica in rapporto alla realtà odierna. Quest'ultima esercita pressioni "difficilmente sostenibili" che non favoriscono l'individuazione. Secondo autorevoli "geopolitici", infatti, nella società attuale si evidenzierebbe la presenza di individui e/o gruppi con un eccessivo amore per se stessi che si rivela, inter alia, cercando il predominio sugli altri. Considerato come tale sopraffazione si presenti oggi diffusamente, quindi anche nei posti di lavoro, questo scritto si focalizza su come sostenere il numero crescente di professionisti che, pur di "successo", chiedono un'analisi, proprio risentendo profondamente di tale clima. Il "movimento progressivo", insieme indicatore e fattore di cambiamento viene studiato nei processi narrativi emergenti dall'attività onirica, incluso il "sognare con le mani nella sabbiera". L'articolo sottolinea come tale "movimento progressivo", fondato sulla competenza narrativa e sulla funzione riflessiva generi, nel co-transfert, forme di "speranza realistica". Quest'ultima segnala l'avvio del processo dell'individuazione nella coppia terapeutica e, simultaneamente, la trasformazione di analista e analizzando in "cittadini del mondo sufficientemente sani".

Narrative competence in Italian children with cochlear implants: a comparison with children matched by chronological or hearing age

ABSTRACT The present study aimed to analyse the narrative competence of a group of Italian children with a bilateral cochlear implant (CI) implanted before 30 months of age. Participants were ten children with CI (aged from 42 to 83 months) and two control groups of typically hearing children one-to-one paired by sex, non-verbal reasoning, and chronological or hearing age. A story generation task, specifically developed to assess narrative skills in children (i.e., the Narrative Competence Task) was used to evaluate both macrostructural and microstructural features of the children’s narratives. Results showed that children with CI presented only one significant difference in the macrostructural aspects of narratives compared to typically hearing children matched by hearing age, specifically in the higher number of events told. In addition, concerning microstructural features, the only statistically significant difference was a lower lexical variety in the narratives produced by children with CI than in those produced by typically hearing children matched by chronological age. Both macrostructural and microstructural indices appeared to be related to the hearing age of children with CI. Early CI appeared to play a crucial role in the acquisition of a complex area of language development, as narrative competence.

Narrative Representation of Medical Student Periodicals

The relevance of the study is due to the need to research medical student periodicals as a source of narrative medicine. The aim of the study is to find out the features of the narratives of medical student periodicals. Research methodology.To achieve the goal of the research the method of narrative analysis was applied, according to the method an analysis was carried out, monitoring of medical student publications for the presence of narratives, classification of their types, and separation of structural units have been done. Using the methods of correlation and synthesis, the thematic section of the available narratives and their correlation with the performed functions have been clarified. Having applied the method of sociological survey, in particular, by conducting the focus group survey of interns of different specialties, the positions of the respondents on the expediency of acquiring and applying the narrative competence by future doctors and creative cooperation with the student periodicals have been focused.Results. Monitoring and the narrative analysis have shown that student medical publications represent several types of narratives. These narratives are distinguished by the specific thematic sections, functionality and structural units. Not only does biographical narrative tell the story of eminent scientists, doctors, students, and the professional development of a person in the medical field, but also sets a pattern for imitation, serves as a source of deepening medical knowledge and motivation for successful professional activity. The presence of authoritative subjectivism, the incorporation of the quotations of the described people helps to establish an identity between the narrative hero, his author and the reader. Narrative stories about the disease in the context of current events contribute to the generalized knowledge, information, and experience of a particular disease treating, serve as a reminder for patients in preventing such a disease. The main purpose of narratives — case stories — is to represent an algorithm of action for medical students, interns, and other physicians in the case of similar life and professional experience.Novelty. The narratological potential and functionality of texts of periodicals of medical students have been studied. It has been found out that reading narratives helps the future specialists in the practice of gaining medical education, gaining experience of medical practice, diagnosis, widening their horizons. The narrators themselves are helped by narrators as a therapeutic process of joint reflection of a problem, a clinical case, constitution of their experience, awareness of themselves as specialists.The practical significance of the study. The results of the study will comple-ment to the scientific research on general narratology, medical narratives in general, and rethinking the phenomenon of student periodicals in particular.

Narrative production in autistic adults: A systematic analysis of the microstructure, macrostructure and internal state language

While narrative competence has been well documented in autistic children and young adolescents, fairly little is known about narrative performance of autistic adults. However, narrative abilities continue to develop well into adulthood. Hence, the main objective of the present study is to provide a clearer linguistic and communicative profile of ASD in adulthood by performing a systematic description of narrative performance in autistic adults. A specific annotation scheme was developed to code narrative production, in order to be able to compare the production of autistic participants to pairwise matched neurotypical adults relative to microstructure (syntactic complexity), macrostructure (overall story structure and cohesive ties) and internal state language of the corpus' narratives. The results suggest that autistic adults performed worse than their neurotypical peers on all three dimensions of narrative production, resulting in less coherent narratives overall for autistic adults.

Longitudinal effects of second language on first language narrative skills and executive functions of preschool children

The present study investigated the longitudinal effects of early exposure to L2-English on L1-Turkish language competence, narrative skills and executive functioning. We asked whether early immersion-like exposure to L2, starting around 3 years of age, would have reflections on L1 competence, L1 narrative skills and gains in cognitive flexibility. Thirty 4-year-olds attending two types of preschools participated in the study: L1 preschools (N=12) with Turkish instruction and L2 preschools (N=18) where children were exposed only to English (6 hrs) throughout the day. Children were initially tested at time 1 (T1) at age 4 and at time 2 (T2), a year later when they were 5. At T1, results revealed that children attending L2 preschools displayed no differences in executive functions performance compared to children in L1 preschools. Likewise, there were no differences for L1 competence as well as L1 narrative skills. At T2, however, for L1 narrative skills, children attending L1 preschools displayed significantly higher performance compared to peers in L2 preschools. For executive functioning again there were no differences between the participants. The differences in narrative competence at T2 might indicate that children in L2 preschools lack sufficient input in story telling in L1 to support narrative competence. For future consideration how literacy acquisition would interact with the effects of L2 exposure should also be investigated.

The Narrative Competence Task

Abstract. The oral narratives of 240 Italian children aged 3–8 years were analyzed using a new instrument, the Narrative Competence Task (NCT). The data showed a gradual increase in the children’s narrative competence in both the macrostructure and the microstructure. Statistically significant differences between preschool-age and school-age children were found on all the variables considered. In addition to increased chronological age, a significant role of cognitive abilities (general non-verbal intelligence and sequential reasoning) and linguistic skills (mean length of utterance and lexical diversity) emerged in explaining the variance in children’s narrative macrostructure. Children with superior cognitive and linguistic abilities produced richer narratives characterized by a greater quantity of information, a better structure, and a wider use of mental state lexicon.

Invention Questions for Intercultural Understanding: Situating Regulatory Medical Narratives as Narrative Forms

Patient safety narratives are a globally mandated format for representing individual patient experiences, and they include peer-reviewed case reports and narrative medicine. The authors show how the humanistic values described by Carolyn Miller in 1979 could enhance or contribute to international health and medical communication in relation to such narratives. They do so by expanding on twenty-first century work by Bowdon and Scott to provide a framework for considering how narrative competence and narrative humility may allow technical communicators to strengthen their practices within technical communication and the rhetorics of health and science by examining an individual problem within its broader, intercultural contexts.

НАРАТИВНА КОМПЕТЕНТНІСТЬ ЯК СКЛАДНИК ПРОФЕСІЙНОЇ КОМПЕТЕНТНОСТІ МАЙБУТНІХ ПРАКТИЧНИХ ПСИХОЛОГІВ

У статті проаналізовано проблему наративної компетентності практичного психолога як основний складник його професійної компетентності. Показано, що професійна компетентність психолога є складним психологічним утворенням, яке забезпечує успішність його професійної діяльності та включає в себе систему діяльнісно-рольових (знання, уміння і навички) та особистісних (професійно важливих якостей) характеристик, важливе місце серед яких займає наративна компетентність. Наративна компетентність передбачає сформованість в особистості наративу як структурної рамки та наявність «набору» базових наративів, що мають соціокультурну природу, вмінь розгортати наративні структури у зв’язну розповідь або історію. Націленість психологічної допомоги на роботу із запитами клієнтів, що будуються на наративі як історії життя людини, яка звернулася за допомогою, робить надзвичайно важливим вивчення наративної компетентності, що реалізується в процесах розуміння та самопізнання, осмислення та переосмислення активним суб’єктом інформації про навколишній світ і себе в ньому. Виявлено, що наративна компетентність є складником професійної компетентності практичного психолога і засобом усвідомлення ним власного досвіду та власної особистості, що виражається у вмінні побачити за історією особистості у ході надання психологічної допомоги її індивідуальний наратив. Зроблено висновок про те, що несуперечлива Я-концепція, рефлексивність, діалогічна спрямованість у спілкуванні, керування почуттями й емоціями інших (складові частини емоційного інтелекту), чутливість-раціональність (складники комунікатинної компетентності) є комплементарними до особистості практичного психолога якостями, наявність яких обумовить забезпечення особистісного зростання клієнта в процесі індивідуальної і групової роботи.

DEVELOPMENT OF DIAGNOSTIC TOOLS FOR DETERMINING LEVELS OF PERSONALITY’S NARRATIVE COMPETENCE FORMATION

The study concerned elaboration and testing of methodological tools for determining the development levels of narrative competence. These texts structurally consisted of three stages: selection of necessary narrative material for processing; development of diagnostic tasks for selected texts of narratives including criteria of formation of personality’s narrative competence and algorithm for determining certain level of personality’s narrative competence formation; involvement of a panel of experts to access the levels of respondents’ narrative competence.

Content and outcomes of narrative medicine programmes: a systematic review of the literature through 2019

ObjectivesNarrative medicine (NM) incorporates stories into health sciences paradigms as fundamental aspects of the human experience. The aim of this systematic review is to answer the research question: how effective...

Програма розвитку наративної компетентності особистості

Програма розвитку наративної компетентності особистості

ScribeMD: Mixed-methods analysis of a pen pal program in undergraduate medical education

Introduction: A growing emphasis on humanistic medical care has led to the development of programs to imbue more humanistic values into training physicians. The ScribeMD intra-class pen pal program is a narrative medicine tool designed to meet this need with a focus on the journey through medical education. This study intends to evaluate the efficacy of this novel program on the participants’ professional identity formation (PIF), emotional intelligence development (EID), and narrative competency improvement (NCI).Methods: This program evaluation involved quantitative and qualitative survey solicitations from first and second-year medical student participants and controls. An efficacy-triangulation model was developed as a quantitative outcome-measuring tool linking objective, writing prompts, and survey data.Results: The quantitative results showed statistically significant improvements in line with the Efficacy Triangulation Model in the participant group. Qualitatively, reflective and insight-driven gains were elicited, as were notable themes of personal and community improvements.Conclusion: ScribeMD poses a unique avenue for the development of more humanistic physicians during their medical education. We recommend additional development of the Efficacy Triangulation Model as well as the program design itself. We also recommend the piloting of this program in other healthcare-education settings both with medical education and other health professions.

The effect of linguistic comprehension instruction on generalized language and reading comprehension skills: A systematic review.

The effect of linguistic comprehension instruction on generalized language and reading comprehension skills: A systematic review.

Narrative medicine: A useful approach for difficult conversations.

6 Background: Narrative medicine (NM) is acknowledged as an effective approach for valuing patient and provider experiences. The NM approach requires developing narrative competence to “recognize, absorb, interpret, and honor” the stories of self and other (Charon, 2010). Given the difficulties providers face engaging in end-of-life (EOL) and advance care planning (ACP) conversations, this study reports the results of a NM workshop to 1) develop skills in attending and responding to the stories of others as part of ACP conversations and 2) reflect on their own stories of loss in relation to their professional practice. Methods: 80 health care professionals participated in a workshop on NM principles for end-of-life care and completed both pre- and post-workshop surveys. Workshop activities included a close reading on a professional’s story of personal loss and a reflective writing exercise sharing one’s own personal story of loss. Small groups debriefed after each exercise. 2 participants were current students and were dropped from analysis, for a final analytic sample of 78. Participants completed surveys at baseline and at the conclusion of the workshop. Surveys included questions on participant demographics, confidence for EOL conversations, and the ACP Self Efficacy scale. Descriptive statistics were calculated for sample demographics and post-workshop evaluation questions. A paired sample t-test was used to compare ACP Self Efficacy scores pre- and post-workshop. Confidence for EOL conversations was compared pre- and post-workshop using Kendall’s tau-b. Results: The mean age of the sample was 46.6 years (SD 13.1), 94% were female, and 82% were White. Social workers represented 84.6% of the sample. 53% of the sample reported having some type of advance care directive for themselves. Self-efficacy for engaging in ACP conversations increased from pre- to post-workshop (p < 0.0001) and there was a statistically significant improvement in confidence discussing death and dying from pre- to post-workshop (p = 0.004). Conclusions: NM competencies improve self-efficacy and confidence for engaging in ACP and EOL conversations. Providers find the NM approach to be a useful framework for engaging in difficult conversations about end-of-life.

“I’m sure that there is something healing in the writing process”

The University of Southern Denmark has introduced a mandatory course in Narrative Medicine into the curriculum of undergraduate medical students. It is part of a trajectory called ‘Human First’, which aims to improve the students’ empathic abilities by teaching them narrative competencies to draw on in their future clinical encounters as medical doctors. Although, theoretical accounts seem to make a strong case for the utility and value of educational interventions, such as courses in narrative medicine or medical humanities, there has been a lack of empirical studies providing evidence to support such accounts – especially those focusing on the long-term effects and impact on patient care. Our systematic literature search and review of empirical studies regarding the effects of teaching close reading of fictional texts and creative writing to medical and health care students, tentatively confirmed previous indications of positive effects. Larger, multi-site and more rigorous studies that assess the long-term impacts of these educational interventions and adjust for local variations are, however, still in short supply. Finally, we present critical reflections on whether empathy and similar phenomena are at all measurable and discuss the possibility of meaningfully evaluating the utility of curricular interventions such as narrative medicine courses.

‘Human First’: Teaching close reading and creative writing to medical students

The University of Southern Denmark has introduced a mandatory course in Narrative Medicine into the curriculum of undergraduate medical students. It is part of a trajectory called ‘Human First’, which aims to improve the students’ empathic abilities by teaching them narrative competencies to draw on in their future clinical encounters as medical doctors. Although, theoretical accounts seem to make a strong case for the utility and value of educational interventions, such as courses in narrative medicine or medical humanities, there has been a lack of empirical studies providing evidence to support such accounts – especially those focusing on the long-term effects and impact on patient care. Our systematic literature search and review of empirical studies regarding the effects of teaching close reading of fictional texts and creative writing to medical and health care students, tentatively confirmed previous indications of positive effects. Larger, multi-site and more rigorous studies that assess the long-term impacts of these educational interventions and adjust for local variations are, however, still in short supply. Finally, we present critical reflections on whether empathy and similar phenomena are at all measurable and discuss the possibility of meaningfully evaluating the utility of curricular interventions such as narrative medicine courses.