From dispensing to caring: Enhancing patient-provider relationships through parallel chart writing in a...

Narrative medicine and reflective writing, specifically parallel charts, are established tools for fostering empathy in medical education; however, empirical evidence in clinical pharmacy education remains limited. This study evaluated the feasibility and educational impact of integrating parallel chart writing into a pharmacist-managed outpatient clinic.

A convergent mixed-methods study was conducted from May 2024 to December 2025 involving 40 pharmacy trainees [27 interns and 13 Post-Graduate Year (PGY) pharmacists]. Feasibility was assessed via completion rates and a 5-point Likert satisfaction survey. Quantitative evaluation of narrative competence used faculty-assigned scores (0-100 scale), analyzed with Welch's t-test and Cohen's d effect sizes. Qualitative data from 40 parallel charts, 40 reflections, and 24 semi-structured interviews were subjected to inductive thematic analysis.

The primary objective of feasibility was met, with a 100% completion rate and high trainee satisfaction (4.75 ± 0.31), particularly regarding the enhancement of patient-provider relationships (4.93 ± 0.27). The mean score for parallel charts was 86.28 ± 5.54. Subgroup analysis revealed that prior narrative experience was the sole factor influencing performance (91.50 ± 1.52 vs. 85.35 ± 5.48; p < 0.001; Cohen's d = 1.15), whereas clinical seniority showed minimal impact (d = 0.49). Four qualitative themes emerged: (1) awakening and deepening of empathy; (2) facilitation of deep reflection; (3) professional identity shift from "dispenser" to "caregiver"; and (4) positive acceptance of narrative pedagogy as a supplementary clinical tool.

Parallel chart writing is a feasible and effective pedagogical tool in pharmacy education. Since narrative competence does not automatically improve with clinical seniority, structured training is essential. This intervention bridges the gap between technical proficiency and holistic care, potentially strengthening therapeutic alliances and medication adherence.