Assessing the effects of interventions of narrative medicine in the training of care professionals: experiences and reflections

Abstract

Since the beginning of the 2000s, many interventions based on narrative medicine (NM) approach have been introduced at various levels of health professionals training, all over the world. Sev-eral publications have described strategies, methods and materials used in this type of interventions, but few have evaluated the outcomes of narrative and reflective practices. This contribution explores the issue of evaluating NM programs, on which some systematic reviews have focused in recent years. Evaluating the results of NM programs cannot be reduced to collect-ing data on the perception of them by participants, and/or to assessing knowledge/attitudes developed by professionals, but requires investi-gation of the impact on their behaviors and, ultimately, on the pa-tient’s well-being. Literature points out that NM programs may ensure promising outcomes (i.e. development of communication skills, empathy, cultural competence, professionalism, and burnout mitigation), but a few stud-ies report the evaluation of these educational practices, especially in the long period, and, when NM programs are evaluated, design and instruments appear very weak. The few studies that reported evalua-tion strategies considered "well described" and based on a "robust" design, are those that had a pre-post test or clinical trial design, and mainly used validated tools for assessment. This contribution critically reflects on these results, reminding that NM originates from the Phenomenological-interpretative paradigm, which is based on the search for meaning. Therefore, this paradigm should also guide evaluation practices, which should be conducted rigorously and, above all, in a critical and reflective manner.