Impact of Early Implementation of Narrative Medicine Techniques on Patient Centered Attitudes of Medical Students

NCT03041571 | Withdrawn

• 1 other identifier: IRB201601597
• Study Type: observational
• Target: N/A
• Locations: 1 country
• Sites: 1

Brief Summary

A qualitative study assessing the impact of early narrative medicine practice on Medical Honors Program (MHP) students' attitudes regarding patient-centered interactions, through interviewing patients with chronic or life-limiting illnesses to obtain their illness stories. MHP students will develop a patient narrative for the patients interviewed. These narratives will be edited by the patient, and, with the permission of the patients, may be published as a collection of stories.

Conditions

Narrative Medicine; Chronic Disease; Terminal Illness; Cancer; Diabetes Mellitus; Cystic Fibrosis; Rheumatologic Disorder; Oncologic Disorders; Hematologic Diseases

Outcome Measures

Primary Outcomes (1)

• Patient provider orientation scale score (PPOS)

  The PPOS is an 18 item questionnaire developed to evaluate patient centered care. The items are rated on a 6 point Likert-type scale. It has two separate parts, sharing and caring, that can be either summed or divided for scoring purposes. Higher scores indicate more patient centeredness.

  baseline

Secondary Outcomes (4)

• Patient provider orientation scale- "Sharing" portion

  baseline

• Patient provider orientation scale- "Caring" portion

  baseline

• Patient and Student post-interview discussion

  immediately post-interview, up to 1 day

• Medical honors students focus group

  following completion of all MHP/Patient interviews, up to 4 months

Study Arms (2)

Medical Honors Students

The Medical Honors Program students will fill out the Patient Provider Orientation Scale (PPOS). MHP students will then interview a patient with a chronic or life limiting illness.

Behavioral: Patient Provider Orientation Scale; Behavioral: Interview performed by MHP student

Patients with chronic illnesses

The patients will fill out the PPOS scale. The patient will then have an Interview performed by MHP student

Behavioral: Patient Provider Orientation Scale; Behavioral: Interview performed by MHP student

Interventions

Patient Provider Orientation Scale BEHAVIORAL

Investigators are interested in the impact that our activity has on the students' patient-centeredness. Investigators will use the Patient-Practitioner Orientation Scale (PPOS), which will be completed by both the student and the patient prior to the encounter. Following the interview, the co-investigators will lead a discussion with the patient and student. Investigators will discuss differences in patient and student PPOS scores, and how each party felt the interview went. Investigators will examine if the patients feel the interview differed from typical interactions with health care providers, and how this made the patient feel. The students will describe what was learned from the patients story as well as try to explore reasons why providers may not always learn the patient's illness story.

Medical Honors Students; Patients with chronic illnesses

Interview performed by MHP student BEHAVIORAL

The MHP students took a course called Medical Humanities in the fall of 2016. MHP students learned patient interviewing skills and the importance of gathering the patients "illness story". The students will conduct an interview with a patient with chronic illness, which will be focused on gather information about how the patients illness affects daily life as well as interactions with the health care system.

Medical Honors Students; Patients with chronic illnesses

Eligibility Criteria

• Age: 8 Years - 100 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Study population is two-fold. First the MHP students will be recruited and consented. Their participation is voluntary and will not affect their grades. Second, patients will be recruited based on the inclusion and exclusion criteria.

You may qualify if:

• Patient of Shands UF Health or Shands Children's hospital
• Children must be at least 8 years old
• Patients diagnosed with chronic or potentially life-limiting illnesses
• Patients must be English speaking
• UF students enrolled in the Medical Honors Program
• Medical Honors students must be up to date on HIPAA training and Confidentiality statement agreement
• Students must take the Medical Humanities course
• UF college of medicine students

You may not qualify if:

• Anyone that the medical social worker or Child life specialist feels would be unwilling or unable to participate in the study
• Patients who at the time of interview are unfit to communicate (ex. Ventilated, comatose)
• Patients less than eight years old
• Patients that do not speak English
• Students not enrolled in the UF College of Medicine
• Students not enrolled in the Medical Humanities course

Sponsors & Collaborators

• University of Florida: lead

Study Sites (1)

University of Florida

Gainesville, Florida, 32611, United States

Location

Related Publications (10)

• Batt-Rawden SA, Chisolm MS, Anton B, Flickinger TE. Teaching empathy to medical students: an updated, systematic review. Acad Med. 2013 Aug;88(8):1171-7. doi: 10.1097/ACM.0b013e318299f3e3.

  PMID: 23807099 BACKGROUND

• Hojat M, Vergare MJ, Maxwell K, Brainard G, Herrine SK, Isenberg GA, Veloski J, Gonnella JS. The devil is in the third year: a longitudinal study of erosion of empathy in medical school. Acad Med. 2009 Sep;84(9):1182-91. doi: 10.1097/ACM.0b013e3181b17e55.

  PMID: 19707055 BACKGROUND

• Griffith CH 3rd, Wilson JF. The loss of student idealism in the 3rd-year clinical clerkships. Eval Health Prof. 2001 Mar;24(1):61-71. doi: 10.1177/01632780122034795.

  PMID: 11233586 BACKGROUND

• Haidet P, Dains JE, Paterniti DA, Chang T, Tseng E, Rogers JC. Medical students' attitudes toward patient-centered care and standardized patients' perceptions of humanism: a link between attitudes and outcomes. Acad Med. 2001 Oct;76(10 Suppl):S42-4. doi: 10.1097/00001888-200110001-00015. No abstract available.

  PMID: 11597869 BACKGROUND

• Institute of Medicine (US) Committee on Quality of Health Care in America. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington (DC): National Academies Press (US); 2001. Available from http://www.ncbi.nlm.nih.gov/books/NBK222274/

  PMID: 25057539 BACKGROUND

• Kim SS, Kaplowitz S, Johnston MV. The effects of physician empathy on patient satisfaction and compliance. Eval Health Prof. 2004 Sep;27(3):237-51. doi: 10.1177/0163278704267037.

  PMID: 15312283 BACKGROUND

• Stacy R, Spencer J. Patients as teachers: a qualitative study of patients' views on their role in a community-based undergraduate project. Med Educ. 1999 Sep;33(9):688-94. doi: 10.1046/j.1365-2923.1999.00454.x.

  PMID: 10476021 BACKGROUND

• Krupat E, Bell RA, Kravitz RL, Thom D, Azari R. When physicians and patients think alike: patient-centered beliefs and their impact on satisfaction and trust. J Fam Pract. 2001 Dec;50(12):1057-62.

  PMID: 11742607 RESULT

• Krupat E, Pelletier S, Alexander EK, Hirsh D, Ogur B, Schwartzstein R. Can changes in the principal clinical year prevent the erosion of students' patient-centered beliefs? Acad Med. 2009 May;84(5):582-6. doi: 10.1097/ACM.0b013e31819fa92d.

  PMID: 19704190 RESULT

• Krupat E, Rosenkranz SL, Yeager CM, Barnard K, Putnam SM, Inui TS. The practice orientations of physicians and patients: the effect of doctor-patient congruence on satisfaction. Patient Educ Couns. 2000 Jan;39(1):49-59. doi: 10.1016/s0738-3991(99)00090-7.

  PMID: 11013547 RESULT

MeSH Terms

Conditions

Narrative Medicine; Chronic Disease; Neoplasms; Diabetes Mellitus; Cystic Fibrosis; Collagen Diseases; Hematologic Diseases

Condition Hierarchy (Ancestors)

Narration; Communication; Behavior; Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Glucose Metabolism Disorders; Metabolic Diseases; Nutritional and Metabolic Diseases; Endocrine System Diseases; Pancreatic Diseases; Digestive System Diseases; Lung Diseases; Respiratory Tract Diseases; Genetic Diseases, Inborn; Congenital, Hereditary, and Neonatal Diseases and Abnormalities; Infant, Newborn, Diseases; Connective Tissue Diseases; Skin and Connective Tissue Diseases; Hemic and Lymphatic Diseases

Study Officials

• Robert Lawrence, MD

  University of Florida

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: January 31, 2017
• First Posted: February 2, 2017
• Study Start: March 1, 2017
• Primary Completion: October 18, 2019
• Study Completion: October 18, 2019
• Last Updated: January 6, 2020

Record last verified: 2020-01

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)