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Published on: August 1, 2019
Navigating uncertainty: Narrative medicine in pregnancy options counseling education
Katherine Rivlin1, Carolyn L Westhoff1
1Department of Obstetrics and Gynecology at Columbia University Medical Center, New York, New York, USA.
Objectives:
Pregnancy options counseling, or nondirective counseling of patients with unintended pregnancy, is a "necessary competency" for medical students according the Association of Professors of Gynecology and Obstetrics. Narrative Medicine (NM) utilizes stories of illness to inform clinical practice and promotes self-reflection in medical education. The authors analyzed the effect of a NM workshop on medical students' ability to provide pregnancy options counseling.
Methods:
The authors randomized students in the major clinical year at Columbia University Medical Center (CUMC) to either a 2-hour NM workshop or to a control intervention. The NM group participated in reading and reflective writing exercises addressing varying perspectives on pregnancy. Students then completed a video-taped and numerically-scored OSCE (Objective Structured Clinical Examination) regarding pregnancy options counseling. The authors compared mean OSCE scores between the groups.
Results:
The study analyzed 103 participants. Overall mean OSCE scores were higher in the NM group (11.9 ± 1.5, n = 51) than the control group (11.3 ± 1.6, n = 52) (p = 0.049).
Conclusions:
Students undergoing a NM workshop had higher scores on a pregnancy options counseling OSCE.
Practice Implications:
This brief intervention may aid future physicians in providing nondirective pregnancy options. This novel approach to teaching is an easily shared learning tool.
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