A narrative orientation for the longitudinal integrated clerkship

This paper follows through with findings from a longitudinal integrated curriculum (LIC) programme evaluation, which revealed that (1) experiential perspectives and (2) the integration of learning featured weakly in the programme's structure. On examination, these two areas were seen to be linked because, by granting authority to experience, we are called to follow its lead wherever it may take us.

Data was collected from students, clinicians and programme administrators using participatory mapping and discussions and analysed through four lenses, one of which was to identify what seemed to be missing or quiet.

Two features of the LIC model were not explicitly structurally supported in the programme: integration of learning and experiential perspectives.

The authors draw on narrative medicine and visual thinking to propose a novel response to the problem, which locates the clinical educator as embodying a narrative orientation to teaching. A narrative orientation affirms the power of human experience, told through stories, to enable integrative, whole-person, big picture thinking in the medical education curriculum. Teaching ideas are scaffolded through metaphors of form, space and integration.

In pursuit of an authentic integrator of learning in the LIC, we already have within our reach the power to grant human experience the authority to teach us wherever we find it and follow wherever it leads. However, its potential is yet to be realised, and this discussion throws up new questions for practical enquiry: how best to support educators to adopt a narrative orientation.