Narrative is an increasingly potent concept for medical educators; developed as a tool to un-cover the patient experience as well as to illustrate the nuances where empathy has a place to fill the gap between the patient and their doctor.
Medical humanities, then, has an integral role for students learning how to become a doctor; and not just merely a doctor; but ‘Tomorrow’s Doctor’ as envisioned by the General Medical Council.
Narratives require that there is space especially within the clinical encounter to be expressed and received. Of course, medical practice elicits narratives containing some of the most significant elements of the human condition. As well as the narratives being diverse encompassing different beliefs surrounding the meaning of life, death, illness, and health, then, so are the narrators. This means that it is necessary for doctors to be trained in perceiving and receiving another person’s story. This is a moral endeavour and also one of justice in the context of a healthcare system that is based on equality and non-discrimination.
A recent initiative by Maslaha grasped the need for both understanding the patient’s story and the practical implications of working with diverse communities in medical practice. Maslaha (which means ‘for the common good’ in Arabic) is a UK-based organisation working with communities to practically and innovatively tackle long-standing issues around inequality and social justice.
A three-hour preliminary workshop was held at Kings’ College London with 100 fourth year medical students. Structured as four breakout sessions in different locations on campus, each was led by a different facilitator from various disciplines and with a range of expertise—from a professional actor and storyteller to an ex-offender.
The aim of each session was to explore a different practical aspect of working with diverse communities. The sessions were namely:
- Introspective/ critical reflection
- Looking out—the patient; the ‘paper’ version versus the real person
- Looking out—community; what issues, barriers and also resources might exist
- Looking out—national narratives/discourse; how this shapes an individual’s behavior
Comments from the evaluative feedback from students following the workshop revealed the usefulness of the session. For example, ‘made me aware of communities and beliefs that I was not aware of previously’ and ‘concrete examples of barriers to different communities accessing healthcare and resources to help with communication’.
These statements highlight that such a workshop is a portal to understanding the context and needs of a patient who may be marginalized because of aspects pertaining to their origins, cultural orientation, religious belief and community membership. As such, it helps to democratize the clinical approach.
Furthermore, the students felt that it was essential for medical schools to integrate these topics into pre-clinical syllabus/lectures and to teach about diversity especially practical information regarding how to address cultural/religious/spiritual needs. These topics are currently overlooked and/or form a minor component of the teaching, which leads to the student being unaware of the contexts of some of their patients they will be examining and treating as soon as they enter their clinical training, and unequipped with practical skills and tools to overcome these everyday challenges.
Ideally, Maslala’s workshop on practical implications of working with diverse communities will develop and feature in medical schools across the UK especially in light of our increasingly diverse society and globalized movement—both of patients and doctors.
To learn more about Maslaha, please follow the below link:
http://www.maslaha.org