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Updated: Jun 18, 2026

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
Published on: February 16, 2011
Untold Stories: An Intervention to Rekindle Empathy in Medicine
Jeffrey Lee1, Katherine Kenyon Henderson2, Elissa Rumer Nickolopoulos3
1is a Internist-Psychiatrist in Practice, Southlight Healthcare, and Hospital Medicine Physician, Duke University Health System, Durham, North Carolina, USA.
Background:
Empathy is vitally important in graduate medical education (GME) but may be difficult to sustain amid competing clinical, educational, research, and administrative demands. Medical humanities interventions may foster reflection and perspective-taking, yet few theory-informed interventions have been described in GME and interprofessional settings.
Objective:
To describe the development, acceptability, and feasibility of a visual arts and narrative medicine-based workshop for attending physicians, resident physicians, health care students, and interdisciplinary staff.
Methods:
In 2023, patients at a safety-net primary care clinic participated in semistructured interviews and portrait sessions. Narratives, photographs, and de-identified clinical records created by the author team were integrated into a facilitated, discussion-based, 60- to 90-minute workshop grounded in the PRISM model and visual thinking strategies (VTS). Authors facilitated interventions across 6 settings, guiding structured observation and reflection of a single patient's electronic medical record, portrait, and audio interview. Participants completed post-workshop surveys assessing perceived empathy, understanding of patients' perspectives, and anticipated changes in patient care.
Results:
One hundred fifty-six participants completed workshop evaluations. Most agreed or strongly agreed that the workshop promoted empathy (141 of 156, 90.4%; 18 of 19, 94.7% for residents) and would positively influence their approach to patient care (144 of 156, 92.3%; 17 of 19, 89.5% for residents). Open-ended responses emphasized multidisciplinary perspectives and recognition of patients as whole individuals. The workshop was feasible to implement using standard educational time blocks, 2 facilitators familiar with VTS principles, and minimal audiovisual materials. This intervention is ongoing and being adapted within undergraduate medical education and GME.
Conclusions:
This theory-informed humanities-based workshop was acceptable and feasible across diverse educational settings and learners.
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