The Power of Patient Narratives: Learning through Storytelling 

By: Claire Jahnke, PharmD Candidate and Ashley Castleberry, PharmD, MAEd

I’ve previously shared my story about my experiences on both sides of the patient-practitioner relationship. When discussing potential strategies to enhance the student learning experience at my college of pharmacy, I recognized that the early development of affective skills, such as empathy, was one area where I could impact my program.   

What I Hoped:

My goal was to see my peers slow down and consider what it would be like to live these patients’ lives, day in and day out. Most importantly, my goal was to show future practitioners that patients were not passive or mechanical beings. Instead, they are active, conscious individuals with unique perspectives, experiences, and autonomy.

What I Did:

I identified, adapted, or created five sets of essays or videos that narrated elements of the patient experience. These patient stories aligned with pharmacotherapy content in the second-year curriculum and encompassed disease states such as chronic kidney disease, cystic fibrosis, heart failure, diabetes, and meningitis. These topics were selected due to the longitudinal nature of disease state management. In addition, several of the patient narratives were centered on the experiences of pediatric patients or young adults, to facilitate a greater sense of relation and connection from the pharmacy students. 

Second-year pharmacy students were provided patient narratives during an interactive lab class, participated in small and large-group discussions, and then were directed to complete a short (3-5 sentence) reflection using the “What? So what? What now?” model.¹ These reflections were then analyzed to evaluate how students engaged with patients’ stories. We conducted a qualitative thematic analysis using random sampling on each group of reflections, as well as utilized a large language model (ChatGPT) to identify the most common themes in the reflections. 

What I Found:

We found that students showed active engagement with the narratives and reflected on the content. Only a minority of reflections showed surface-level commentary without consideration. This suggests that the narratives were overall an effective learning tool. While reflecting on our qualitative analyses, we identified three global  takeaways. 

1. Students engaged with the narratives. It was clear that patient narratives have a real impact on more than just affective skills. The reflection did show that students gained an appreciation for the role of person-centered care and the need to be cognizant of how they communicate with patients. However, many students also commented on the value of the patient narratives in supplementing the didactic content of pharmacotherapy courses. They mentioned that the information was now more memorable and that it helped them “see” what was taught in class.

2. Students’ intensity of reflection varied. Narratives were selected to ensure that students could put themselves in the patients’ situation. However, it was more common for students to respond intellectually or with basic emotion than a sense of relating. The majority of reflections showed reflection on the content of narratives in abstract terms. Concepts such as the role of a pharmacist, the importance of communication, and the use of interventions such as CPR and immunizations were commonly discussed. When students did engage emotionally, the most common response was a sense of “feeling sorry” for the patients. Notably, reflections that demonstrated a sense of relating (e.g. “I can’t imagine what it would be like to have this happen to me”) occurred more frequently in narratives that showcased patients in college or pharmacy school. 

3. Students don’t know what they don’t know. The experiences were characterized as “eye-opening” and that the stories presented situations that students had “never thought about before”. Although the reflection prompt encouraged broad thinking, few students extended their empathy beyond the story to proactively consider how patients might face other challenges in life. 

What’s Next?

While the results of our patient storytelling interventions appear to have promising results, there is still room to optimize the outcomes of this project. Researchers at UTMB have recently explored the use of “Lived Experiences Panels” in undergraduate medical education to leverage patient narratives with a more direct and personal touch.² Such panels could be a valuable tool in expanding understanding and relating³ as:

• Students can physically see and hear from those with lived experiences.
• Panelists can directly state what they hope their providers will think about. 
• Health profession educators can tailor the discussion to learning objectives. 
• Narratives can be adapted to incorporate more information about patients’ medication regimens in order to more directly support didactic pharmacotherapy by making the content more memorable.⁴

As this project moves forward, we are considering places within the curriculum where panel or direct interviews may be utilized to support student learning. One of the students put it like this: “It’s always helpful to see the life experiences of patients because it helps us see the human aspect of disease.” How will you bring patient narratives into your classroom?

References: 

1. Jacoby B, Mutascio P. Looking in Reaching out: A Reflective Guide for Community Service-Learning Professionals. Campus Compact; 2010. 

2. ​​Patel P, Ahmed N. 12 Tips for Centering Patient Voices through “Lived Experience Panels” in Preclinical Undergraduate Medical Education. MedEdPublish. 2024;14:23-23. doi:10.12688/mep.20260.1 

3. Moreau KA, Eady K, Sikora L, Horsley T. Digital storytelling in health professions education: a systematic review. BMC Medical Education. 2018;18(1). doi: 10.1186/s12909-018-1320-1

4. Easton G. How medical teachers use narratives in lectures: a qualitative study. BMC Medical Education. 2016;16(1). doi:10.1186/s12909-015-0498-8

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Author Bio(s): 

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Pulses is a scholarly blog supported by a team of pharmacy educators.