Expanding the Scope of Narrative Medicine by Emphasizing Stories from Minoritized Communities: A Novel Facilitator Training Program

Background: Narrative medicine (NM) emphasizes the vital role healthcare stories play in conveying patients' experiences and expanding health professionals' reflective capacity. Though predicated on inclusivity, social justice, and equality, NM programs do not tend to include communities with marginalized health narratives due to a paucity of trained facilitators.

Objective: To evaluate the impact of a novel virtual NM facilitator training intended to expand NM programming to minoritized communities.

Design: Mixed methods analysis of surveys administered before (pre), after (post), and 6 months after (6mo follow-up) the training.

Participants: Healthcare professionals, scholars, caregivers, and patients self-identifying as a member of (n = 25/42, 60%) and/or working with (n = 36/42, 86%) minoritized community groups.

Main measures: Perceived confidence and skills relating to NM and facilitating NM activities, and open-ended questions about the curriculum across three timepoints.

Interventions: Training occurred over eight half-day sessions with large group plenaries, facilitated small groups, and art and humanities workshops.

Key results: Response rates were n = 34/42 (81%), n = 29/42 (69%), and n = 21/42 (50%), respectively, for the three timepoints. Compared to pre-training, post- and 6mo follow-up surveys showed statistical improvements on six of seven items, including confidence and skill in facilitating NM activities (mean = 3.2 vs. 5.5 vs. 5.4), creating NM curricula (mean = 3.1 vs 5.2 vs. 5.2), defining narrative competence (mean = 4.2 vs. 5.5 vs. 5.3), engaging team members (mean = 4.7 vs. 5.7 vs. 5.5), identifying humanities materials (mean = 3.3 vs 5.0 vs. 5.1), and recognizing diverse perspectives (mean = 4.6 vs. 5.5 vs. 5.5). Pairwise comparisons showed post- and 6mo follow-up responses significantly increased (p ≤ 0.01) from pre-training. Participants reported facilitating more NM activities after training (mean = 1.5 vs. 1.9; p = 0.006).

Conclusions: We successfully recruited and engaged participants from minoritized communities to facilitate NM sessions. Future efforts should focus on objective assessments of skills, and more in-depth research using focus groups, observation, and key informant interviews.