NEH: Patient Health Through Narrative Medicine
In 2000, a grant from the National Endowment for the Humanities gathered group of clinicians and scholars at Columbia University to establish a collaborative learning seminar. The group explored, discovered and began to articulate the consequences of bringing literary and creative practices into the realms of healthcare. The discipline of Narrative Medicine emerged, and in honor of the NEH’s 50th anniversary in 2015, this grant was named one of the top 50 out of 63,000 lifetime grants they have awarded.
NIH K07 Academic/Teacher Award Grant
Rita Charon and the Division of Narrative Medicine were awarded a NIH K07 Academic/Teacher Award grant to gather medical school preceptors at Columbia University’s Vagelos College of Physicians and Surgeons. The Foundations of Clinical Medicine course was an established, mandatory course for all preclinical medical students at VP&S. With the K07 grant, Rita introduced the group to the principles and practice of Narrative Medicine. The group began to discover the centrality of Narrative Medicine to medical training and relevance to this already established course–and began to incorporate Narrative Medicine into the FCM curriculum. VP&S preclinical students are placed into a small group and meet weekly with their preceptor, where they engage in narrative medicine work. Once a semester, students write a Signature Reflection, which is stored in the student’s portfolio and available as a point of reference when the students begin to apply to residency programs.
Josiah Macy Jr. Foundation Interprofessional Education Grant
Simultaneously, the Division of Narrative Medicine pioneered interprofessional healthcare team-based learning with the help of a board grant from the Josiah Macy Jr. Foundation. Originally termed the Macy Group, following the end of the grant they renamed themselves Columbia Commons for IPE: Collaboration Across Professions. Twice a month, key leadership from the School of Nursing, Public Health, Physical Therapy, Occupational Therapy, Nutrition, Medicine, Dentistry and Pastoral Care gather to discuss, design, plan and execute interprofessional learning actives for students. The Commons serves as a breeding ground for interdisciplinary research, and multiple projects among students and faculty have emerged as a result of this group. Unique to Columbia, the Commons distinguishes itself from other interprofessional initiatives by using narrative methods of inquiry as its foundation. Each Spring semester, the Commons offers an interdisciplinary credit bearing seminar to all CUMC students.
Over the course of this project, Columbia diverged from the mainstream national currents in IPE. Through our involvement with IPEC and the National Center for Interprofessional Practice and Education at the University of Minnesota, we are well aware of the skills-based approaches often adopted elsewhere. Through a ten-year collaboration with colleague schools in a broad NIH-funded grant program in enhancing social science and behavioral science curricula in medical schools, we have worked closely with an IPE sub-group of health professionals at Oregon Health Sciences University, University of California at San Diego, UCLA, Indiana University, University of Texas at San Antonio, and Brown University. Some if not many of the programs at other institutions in the US emphasize joint learning of concrete interprofessional skills: learning each profession’s specific role in clinical situations, training for courtesy toward members of other professions, and check-listing approved behaviors in clinical simulations.
In contrast, the emerging philosophy and approach to IPE at Columbia is focused less on specific tasks completed by each role, and more on shared values and ways to work together to produce better healthcare for the patient. Our narrative approach results in individual-to-individual contact within the context of health care teams. We don’t gather to discuss operating room checklists or who does what at the cardiac arrest code. Instead, whether with faculty groups or student groups, we invite participants to grapple with fundamental issues of the human condition. Each of our courses and seminars devotes some time to intensive close reading and creative writing, in addition to more conventional seminar discussions. Through rigorous and guided examination of cultural works—literary texts, visual images, or performative arts—groups of participants can meet within a shared confrontation with powerful carriers of meaning. This is not as obscure as it sounds: together, a group will read a poem or a paragraph from a great novel or watch a clip of a movie or look slowly at a painting. They talk about it; they work at what it says or shows; they learn how diverse are their individual perspectives on the work. They are invited to write—spontaneously, in just a few minutes—about their trains of thought released by the work. When they read aloud or tell about what they’ve written, they achieve privileged views of their own and one another’s subjectivity. Within a half-hour, they’ve enjoyed intimate contact with their own and their colleagues’ deep ways of knowing of the world.
Due to the high demand for seats in the narrative medicine-based Columbia Commons seminar, the Division of Narrative Medicine offers school specific electives in Medicine, Nutrition, Dentistry, Physical Therapy and Occupational Therapy. Narrative Medicine work is integrated into mandatory coursework for medical and physical therapy students.
Clinician-Focused Narrative Medicine Groups
Aligning with mission to revolutionize healthcare teams throughout the use of narrative medicine, we offer Narrative Medicine rounds to a variety of groups affiliated with NYP/CUMC. We host rounds with NYP Social Workers, Emergency Department staff, and OBGYN hospital staff. We have been holding rounds with family medicine residents at the Allen Pavillon for more than 15 years. We also host social work oncology writing groups with patients.
Lang Youth Medical Program at NYP
We connect with future medical scholars in The Lang Youth Medical Program. Beginning in seventh grade, a group of students from Manhattan are selected to participate in this six year long science enrichment and internship program offered through Columbia University Medical Center and New York Presbyterian Hospital. Each spring, the Division of Narrative Medicine hosts a six week long Narrative Medicine workshop series. This workshop series introduces students to the framework of Narrative Medicine, while also allowing them to experience its practice first hand.
Literature at Work
For more than a decade, we have hosted an interdisciplinary reading group, Literature at Work, open to all CUMC/NYP employees and staff. Learn more >>