“What's Important to You?”: The Use of Narratives To Promote Self-Reflection and To Understand the Experiences of Medical Residents

Medical Writings6 August 2002“What's Important to You?”: The Use of Narratives To Promote Self-Reflection and To Understand the Experiences of Medical ResidentsDonald W. Brady, MD, Giselle Corbie-Smith, MD, and William T. Branch Jr., MDDonald W. Brady, MDFrom Emory University, Atlanta, GA 30303Search for more papers by this author, Giselle Corbie-Smith, MDFrom Emory University, Atlanta, GA 30303Search for more papers by this author, and William T. Branch Jr., MDFrom Emory University, Atlanta, GA 30303Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-137-3-200208060-00025 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Too often we hear housestaff speak of residency training as a “test of survival”—getting through the next 3 years so that they may get on with their “real” careers. However, we as faculty physicians know that these years of training are not lived in a vacuum but are inextricably interwoven into the fabric of residents' personal and professional lives. Their experiences—both the highs and the lows—will profoundly influence them as future physicians. For example, when a resident attends to a patient who is dying, how he or she processes that experience will bear markedly on how that resident will react ...References1. Branch W, Pels RJ, Lawrence RS, Arky R. Becoming a doctor. Critical-incident reports from third-year medical students. N Engl J Med. 1993;329:1130-2. PMID: 8371749 CrossrefMedlineGoogle Scholar2. Hupert N, Pels RJ, Branch WT. Learning the art of doctoring: use of critical incident reports. Harvard Student BMJ. 1995;3:99-100. Google Scholar3. Branch WT, Pels RJ, Harper G, Calkins D, Forrow L, Mandell F, et al . A new educational approach for supporting the professional development of third-year medical students. J Gen Intern Med. 1995;10:691-4. PMID: 8770723 CrossrefMedlineGoogle Scholar4. Kitzinger J. Qualitative research. Introducing focus groups. BMJ. 1995;311:299-302. PMID: 7633241 CrossrefMedlineGoogle Scholar5. Glaser BG, Strauss AL. The Discovery of Grounded Theory: Strategies for Qualitative Research. Chicago: Aldine Publishing; 1967:101-15. Google Scholar6. Denzin NK, Lincoln YS. Handbook of Qualitative Research. Thousand Oaks, CA: Sage; 1994:643. Google Scholar7. Schoen DA. Educating the Reflective Practitioner. San Francisco: Jossey-Bass; 1987. Google Scholar8. Miller SZ, Schmidt HJ. The habit of humanism: a framework for making humanistic care a reflexive clinical skill. Acad Med. 1999;74:800-3. PMID: 10429589 CrossrefMedlineGoogle Scholar9. Smith CS, Irby DM. The roles of experience and reflection in ambulatory care education. Acad Med. 1997;72:32-5. PMID: 9008565 MedlineGoogle Scholar10. Branch W. Notes of a small-group teacher. J Gen Intern Med. 1991;6:573-8. PMID: 1765874 CrossrefMedlineGoogle Scholar11. Novack DH, Suchman AL, Clark W, Epstein RM, Najberg E, Kaplan C. Calibrating the physician. Personal awareness and effective patient care. Working Group on Promoting Physician Personal Awareness, American Academy on Physician and Patient. JAMA. 1997;278:502-9. PMID: 9256226 CrossrefMedlineGoogle Scholar12. Novack DH, Epstein RM, Paulsen RH. Toward creating physician-healers: fostering medical students' self-awareness, personal growth, and well-being. Acad Med. 1999;74:516-20. PMID: 10353283 CrossrefMedlineGoogle Scholar13. Branch WT Jr. Professional and moral development in medical students: the ethics of caring for patients. Trans Am Clin Climatol Assoc. 1998; 109:218-29; discussion 229-30. PMID: 9601140 Google Scholar14. Branch WT. The ethics of caring and medical education. Acad Med. 2000;75:127-32. PMID: 10693842 CrossrefMedlineGoogle Scholar15. Mezirow J. How critical reflection triggers transformative learning.. In: Mezirow J, eds. Fostering Critical Reflection in Adulthood: A Guide to Transformative and Emancipatory Learning. San Francisco: Jossey-Bass; 1990:1-20. Google Scholar16. Brookfield S. Using critical incidents to explore learners' assumptions.. In: Mezirow J, eds. Fostering Critical Reflection in Adulthood: A Guide to Transformative and Emancipatory Learning. San Francisco: Jossey-Bass; 1990:177-93. Google Scholar17. Bolton G. Reflective Practice: Writing and Professional Development. London: Paul Chapman Publishing/Sage; 2001:117-8. Google Scholar18. Reynolds PP. Professionalism in residency Editorial. Ann Intern Med. 1991;114:91-2. PMID: 1983943 LinkGoogle Scholar19. . American College of Physicians Ethics Manual. Third edition. Ann Intern Med. 1992;117:947-60. PMID: 1443957 LinkGoogle Scholar20. Stobo JD, Kohen JJ, Kimball HR, LaCombe MA, Schechter GP, Blank LL, et al . Project Professionalism, American Board of Internal Medicine. Philadelphia: American Board of Internal Medicine; 1995. Google Scholar21. Baldwin DC, Daugherty SR, Rowley BD. Unethical and unprofessional conduct observed by residents during their first year of training. Acad Med. 1998;73:1195-200. PMID: 9834704 CrossrefMedlineGoogle Scholar22. Beaudoin C, Maheux B, Côté L, Des Marchais JE, Jean P, Berkson L. Clinical teachers as humanistic caregivers and educators: perceptions of senior clerks and second-year residents. CMAJ. 1998;159:765-9. PMID: 9805021 MedlineGoogle Scholar23. Bolton G. Reflective Practice: Writing and Professional Development. London: Paul Chapman Publishing/Sage; 2001:51. Google Scholar Author, Article, and Disclosure InformationAffiliations: From Emory University, Atlanta, GA 30303Acknowledgments: The authors greatly appreciate the participation of all the internal medicine-primary care residents at Emory University and their continued efforts to become self-reflective, compassionate physicians.Corresponding Author: Donald W. Brady, MD, 69 Butler Street SE, Atlanta, GA 30303; e-mail, email protectededu.Current Author Addresses: Drs. Brady and Branch: 69 Butler Street, SE, Atlanta, GA 30303.Dr. Corbie-Smith: University of North Carolina at Chapel Hill, Medical School, Wing D, CB#7240, Chapel Hill, NC 27599-7240. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byUnderstanding the lived experiences of medical learners in a narrative medicine course: a phenomenological studyHow does narrative medicine impact medical trainees’ learning of professionalism? 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Descriptions of Emotionally Powerful Patient DeathsSelf-Reflection in Multicultural Training: Be Careful What You Ask ForUsing reflective writing within researchPoetic License: Writing Poetry as a Way for Medical Students to Examine Their Professional Relational Systems.The Effects of Sleep Loss and Fatigue on Resident–Physicians: A Multi-Institutional, Mixed-Method StudyWhat Do Doctors Find Meaningful about Their Work?Carol R. Horowitz, MD, MPH, Anthony L. Suchman, MD, William T. Branch Jr., MD, and Richard M. Frankel, PhD 6 August 2002Volume 137, Issue 3Page: 220-223KeywordsEmotionsExerciseForecastingMedical intensive care unitsPatientsResidencyRunningSuicideSurgeonsSurgery ePublished: 6 August 2002 Issue Published: 6 August 2002 Copyright & PermissionsCopyright © 2002 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...