Eligibility: Graduates of Columbia University’s Master of Science in Narrative Medicine program within the past five years (May 2012 through October 2017), who have not previously received a Narrative Medicine Fellowship.
Mission: 1) To advance initiatives in the new field of Narrative Medicine and 2) To contribute to the development of Narrative Medicine graduates as leaders, teachers, and scholars and to create a strong corps of alumnae/alumni with close professional connections to the Program in Narrative Medicine and Columbia University.
Funding: Fellows will be supported for three to twelve months within the range of $500- $4,000.
Application: Alumni are required to submit a Fellowship proposal to the Program in Narrative Medicine by June 15, 2017. Acceptances will be decided by July 1, 2017. The proposal must be a Word or PDF document and should contain the following:
- Title page with project title, graduate’s name and contact information
- Statement of purpose
- Description of the project including
- Location Background Need Previous related work including a literature review (if applicable) o Association with an organization or institution (if applicable) Site supervisor (if applicable) Collaborators (if applicable)
- Products (published article, outcome analysis, presentations, etc.)
Mid-Year and Final Reports: All fellows will be required to submit a mid-year written report, due on February 1, 2018, and a final written report and/or presentation, due by August 31, 2018. Each fellow will be assigned a faculty mentor from the Master’s program in Narrative Medicine.
Charles Ethan Paccione
Narrative Medicine Workshop for Chronic Widespread Pain
Chronic widespread pain (CWP) is considered one of the most common and costly health conditions today. Current forms of CWP treatment; opioids, psychosocial therapy such as cognitive behavioral therapy (CBT) and mindfulness-based stress reduction (MBSR) have left patients and caregivers seeking new and innovative forms of treatment to more effectively and safely address expressions of pain. The values upon which narrative medicine sessions are based (i.e. listening, reflecting, understanding, and communicating) can provide both clinicians and patients with promising avenues for creating a deeper and healthier outlook upon chronic pain treatment and expression. Every patient suffering from CWP can have their own experience of trauma, loss, hardship, and physical and emotional injury – a unique illness narrative. This would be the first investigation of its kind to explore the effectiveness and service of Narrative Medicine when applied to patients suffering from CWP.
Weight Stigma Reduction among Medical Students through Narrative Medicine
This qualitative study uses narrative medicine workshops for medical students to reduce anti-fat bias and increase empathy for the experiences of patients deemed “fat” by current medical standards. The objectives of this study are two-fold. First, to investigate the use of narrative medicine as a stigma reduction initiative in medical education. Secondly, to assess the effectiveness of this initiative to reduce fat stigma in particular. The outcome would entail implementation of a modified narrative medicine workshop format to account for the corporeal, phenomenological barriers that accompany stigma. Workshops will involve pairing medical students with people who have experienced weight-based discrimination in a clinical encounter, as well as dyadic workshopping of a long-term writing project inspired by Narrative Medicine faculty Sayantani DasGupta and Nellie Hermann.
Recording Patient Stories in Clinical Encounter PhotoVoice Training
PhotoVoice (PV) is a method of participatory research and story-taking that brings the subject into an intimate visual space of their narrative. Participants are taught basic photography skills, encouraged to integrate photo capture in their daily lives, and then asked to share stories surrounding images during a facilitated discussion. PhotoVoice could be an excellent way to test the boundaries of Narrative Medicine. Pairing PhotoVoice with Narrative Medicine will allow students and alumni of the program to create an archive of patient and illness stories. The depth of listening changes when new media is introduced, and visual media excites and energizes other forms of understanding and empathy. Sara’s vision is to utilize training in Photo-Voice to then create a Narrative Medicine based Curriculum using this distinct and innovative tool.
A proposal to introduce Narrative Medicine to Istanbul Faculty of Medicine
Figen, a Turkish scholar discovered Narrative Medicine through the amazing TED talk of Dr. Rita Charon entitled Honoring the Stories of Illness. Meeting with Dr. Charon in Greenwich Village and learning more about Narrative Medicine was the first step of her journey, and changed her story going forward. The main objective of her fellowship is to introduce Narrative Medicine as a new field to The Istanbul Faulty of Medicine (IFM). First, by teaching Narrative Medicine to scholars in IFM, and then to create a Narrative Medicine based curriculum that would educate their scholars. Figen believes that altering educational approaches first, in Turkish communities is promising as there is a growing interest in the field of Medical Humanities.
Alexander R. Lichtenberg
This Land is a proposed oral history project based on Alexander’s ongoing ancestral and embodied research. The foundation of his work rests on artists and social justice pioneers like James Baldwin and Maya Angelou, among many others. He also draws inspiration from his own ancestors, German Jews who were traders, bankers, communists, painters, writers, feminists, and survivors, and English, Irish Catholics who fled the potato famine, and other Germans who settled on Indian land in the Midwest. This Land consists of three main components, namely conducting oral histories, facilitating a series of free/donation-based workshops using the main principles of Narrative Medicine (embodiment, storytelling, close reading and listening) and lastly, developing new performance work in the spring of 2018 that draws from this research. The workshops in dance and storytelling are meant to engage with personal and family histories as a way of sharing, expanding insight, and creating possibilities of collaboration and interrelationship. Alexander models this work on Narrative Medicine’s Self & Other course which he has been able to further develop in his own practices through various teaching and choreographic roles.
Narrative Medicine as a Wisdom Practice
Wisdom and narrative practices have fascinated Annie for over 15 years within and outside of academia. The hallmarks of Narrative Medicine—close reading, reflective writing, and collective sharing— seamlessly correspond with and encourage the defining features of wisdom as suggested by theorist and researcher Monika Ardelt. With the support of a Narrative Medicine fellowship, Annie will be able to explore the potential for Narrative Medicine to be taught as a Wisdom Practice with the explicit intention to use the methods to inculcate wisdom. The project will be composed of three parts: to study wisdom spanning philosophy, the creative arts, Eastern and Western spiritual traditions, and contemporary neuroscience, to formulate two curricula, and to culminate in an article entitled “Narrative Medicine as a Wisdom Practice” that will be submitted for publication. Presenting Narrative Medicine as a Wisdom Practice will deepen its application in healthcare and medical education by connecting it with larger wisdom traditions. It will reinforce its application in other settings, and further extend Narrative Medicine’s use for lay populations and spiritual and contemplative communities.
Faiz Jiwani & Jenna Reece
Envisioning Narrative Competence in Medical Education: A Qualitative Study of Narrative Medicine Alumni in Medical School
We are medical students who completed the Master of Science in Narrative Medicine program between our third and fourth year of training during the 2015-2016 academic year. As the Narrative Medicine Master’s Program enters its seventh year, the first alumni classes to complete medical school are now entering residency training programs. This is an opportune moment to examine the impact of the Master’s Program on the medical education experiences of alumni and, through their work, on their peers and faculty. We propose to interview Narrative Medicine alumni who are currently in or have recently completed their medical education to learn how they have used their narrative medicine training in their medical schools. Forty-seven alumni of the Master’s program were either medical students when they enrolled in the MS or applied to medical school upon completion of the degree. We plan to invite these alumni to be interviewed by one of us about their experiences in medical school.
Evaluating Narrative Medicine Practicums: CUMC Lang Youth Program
I propose to evaluate Narrative Medicine workshops at Columbia University Medical Center’s (CUMC) Lang Youth Program in order to explore the impact of narrative methods training for teens/youth, who are in a competitive and specialized pre-health professional track, in developing empathy, self-reflection/awareness, skills of close reading, and attentive listening. An outcome of this project would be to 1) develop Narrative Medicine curriculum for youth and 2) demonstrate the importance and benefit of integrating narrative training with medical education for future health care providers.
Ssanyu Birigwa & Apurva Khedagi
Exploring the Implementation of Narrative Medicine Workshops among Brooklyn Hospital Pediatric Residents
In this qualitative research methods project, we will explore the application of Narrative Medicine as a tool toward wellness, emotional well-being, and self-care. We will be facilitating Narrative Medicine workshops at The Brooklyn Hospital with pediatric residents. Through close reading of various forms of literature, art, and concepts of spirituality, we hope to empower pediatric residents by making self-care and mindfulness practices accessible. We strive to share innovative methods of self-care in graduate medical education through the practice of Narrative Medicine, a fluid, diverse, and potentially powerful medium of personal reflection and coping. We hope to illuminate how art and literature can bring about a different, expansive way of thinking that allows one to listen to one’s own mind and to others.
Applied Phenomenology: An Investigation of the Use and Practice of Theatre/Performance to Develop a Pedagogy and Syllabus for Teaching Core Efficiencies in Narrative Medicine
The aim of this Fellowship is to research, curate and construct a comprehensive pedagogy and companion 12-week syllabus for the purpose of instructing students in the graduate program in Narrative Medicine at the School of Professional Studies, Columbia University. The primary intention is to facilitate for students a “lived experience” of the philosophically-based Narrative Medicine principles of Self and Other. A second but equally vital intention is to generate an embodied understanding of Listening as a core efficiency in the practice of Narrative Medicine. The aim of this Fellowship is to research, curate and construct a comprehensive pedagogy and companion 12-week syllabus for the purpose of instructing students in the Master of Science in Narrative Medicine program at Columbia University. The primary intention is to facilitate for students a “lived experience” of the philosophically-based Narrative Medicine principles of Self and Other. A second but equally vital intention is to generate an embodied understanding of Listening as a core efficiency in the practice of Narrative Medicine.
On Conversational Narratives and Accounts
This research project aims to write a publishable paper on conversational narratives, that is, narratives seen as co-constructed or as interactional achievements (see, e.g., Mishler, 1986; Riessman, 1991 and 2002), and accounts, that is, forms of elicited narratives (see De Fina, 2009). The project proposes that these narrative forms are relevant genres of study that require the attention of Narrative Medicine as an emerging discipline. In this manner, this project intends to advance an initiative in the new field of Narrative Medicine.
Talk about it: Using Narrative and Graphic Medicine to Encourage End of Life Conversations
The purpose of this project is to research and develop a story bank from which a pilot group of four graphic/comic narratives that will get people talking about their values and wishes at the end of life will be created and tested. I will serve as researcher and reviewer of personal end of life stories and as coordinator of the work of the graphic artists and the pilot testing of the graphic narratives as pathways to “talking about it.” I will use the Fellowship to produce an initial series of graphic narratives that depict nuanced end-of-life dilemmas in a form in which patients, family members, and medical professionals can easily imagine themselves. These narratives will gently invite the reader to break longstanding silences and begin “talking about it” in comfort, safety, and good humor. Through my ongoing work with “What Matters” and Gundersen’s Respecting Choices program, I would have the opportunity to pilot test these graphic narratives with groups of seniors and families in a relaxed community setting while pursuing a longer-term goal of achieving broader dissemination through Gundersen and other partner organizations.
Narrative Medicine Program Development at Touro University of California College of Osteopathic Medicine
In Fall 2015, I taught a Narrative Medicine elective to pre-clinical medical students and MPH students, at Touro University California College of Osteopathic Medicine (TUCOM). The elective consisted of nine workshops, and engaged in multi-media texts, including hosting a guest filmmaker. In Spring 2016, I facilitated two workshop sessions for third year osteopathic medical students, in a break between their clinical rotations, and I was a a guest speaker in an elective on reproductive health. I will co-facilitate a faculty development workshop in October, and am in the process of planning a CME workshop.
I also created a Narrative Medicine Clinical Distinction Specialty Track, in which clinical students commit to engaging in Narrative Medicine more deeply. Requirements include: participation in the Narrative Medicine elective, engagement in multi-media texts including books, essays, articles, films, radio podcasts, webinars, writing assignments, interview assignments, the opportunity to participate in a Narrative Medicine CME workshop. As a result of this fellowship, I have been invited to be faculty at the new low-residency MFA program at Dominican University, in San Rafael, CA. In addition, I have served as a resource for consultation and professional development to various care providers in the region, including a FNP in Santa Rosa, and a PA in Forestville, CA. I founded an online platform, The Chronix Project, as a way to highlight and share stories of embodied experience, particularly illness narratives that are under-represented in the genre. I am planning a 6 week online course in writing illness narratives, as well as one for family caregivers of chronically ill patients.
Patte Jodan Huberman
Narrative Medicine Group Program for Psychiatric Inpatients
My fellowship project was to introduce narrative medicine in the hospital where I work, Eastern Long Island Hospital in Greenport. I proposed to do this in two ways: developing a narrative focused patient group on the locked psychiatry unit; and leading narrative medicine workshops for staff groups.In acute care psychiatry, I have worked with many patients who, for their own reasons, are voiceless. Barriers to expression can be imposed on patients by the mandate of a unit as well as by their own internal obstacles: the circumstances of admission alone can construct a story over which a patient has little control, and limited input. Psychiatric illnesses and symptoms often sound pejorative: grandiose, paranoid, delusional, and we risk boxing individual patients into frameworks based on our own assumptions, our own experiences.
Nurses, social workers, counselors and nursing assistants are in the front line of care on the hospital psychiatric unit. It is important that these disciplines as well as physicians learn the importance of close listening and stories to the healing of their patients, and bring this awareness to their practice. This could promote positive changes in their relationships with patients, and with one another. Helping patients access their own stories and be heard can, I believe, have a positive impact on their experience, and their recovery. This approach could also become part of a framework for reducing reliance on PRN (as needed) medications, and influence long term outcomes.
Community-Based Participatory Medical Education: Development of a New Narrative Medicine Intervention
During the spring and summer of 2016, the I developed and piloted a new narrative medicine intervention at the Keck School of Medicine of USC. The intervention was a creative nonfiction writing workshop series in which medical students and patients write and workshop personal narratives. Along with my co-authors, we wrote a paper presenting a mixed methods analysis of the feasibility and efficacy of the intervention. Nine medical students and five patients participated in one of two five-week long workshop series. Pre- and post-workshop quantitative surveys determined changes in perceived professional identity in medical students and perceived social support and quality of life in patients and medical students. Each workshop series concluded with one focus group interview, which the principal investigators analysed to generate a grounded theory. Triangulation of focus group interviews, quantitative measurements, and participant observations enhanced the validity of the results. Ten themes emerged, across three domains. Participants experienced the workshop as a safe and productive environment in which to self-reflect and arrive at deeper understandings of their personal values. It expanded their sense of agency, humanity, and empathy toward others, enabling them to explore and experience new ideals for therapeutic physician-patient relationships. Finally, participants recognized how narrative work can improve health and well-being and believed the workshop has the potential to enact meaningful change on the community level. This workshop series method would be an effective and feasible way for medical schools to improve medical students’ professional identity formation while contributing to community health. Sustainable and multi-institution implementation of this workshop series method is indicated.
Supporting Publications and Presentations
Narrative Medicine alumni and students are applying their skills and furthering their research with amazing results, but too often the only people who hear about it are within the program community. This work should be reaching our colleagues in other academic centers, as well as policy makers, thought leaders and the general public. I had planned to propose becoming a point person for publication. I would research paths to publication and compile a guide that would help students begin to evaluate how best to share their work, perhaps also pointing them toward grants or other support. The ultimate goal is to support alumni and student work to broaden the spread of Narrative Medicine, helping to change the conversation around myriad health-related issues, within academia and in the larger sphere.
Creating a Narrative Medicine Community at Duke University Health System
The goal of this initiative was to create culture change across the Duke Health System, medical school, and undergraduate campus in order to develop a more cohesive, vibrant medical humanities community and supportive humanistic environment for trainees at all levels through incremental, disruptive, community engaged, and vertically integrated projects. For this initiative to be sustainable and create true synergy in arenas with a long history of existing in siloes, it needed to coalesce a community of people engaged in this work at Duke around new ideas and projects. For now, this vast community will gather around stories and storytelling as a common theme central to the wide range of humanistic disciplines. This is a theme that tethers the disciplines to the heart of medicine as it is actually experienced by patients who perceive themselves to be healthy as well as the ill, the suffering, and the dying, along with those who care for them.
Plain Talk Projects: Regarding End-of-Life and Death
This fellowship supported program development utilizing the perspectives of Narrative Medicine and based on the topics/modules introduced in my recently created animated film, Plain Talk. Seminar-based workshops for professionals, wellness organizations, groups (churches, synagogues, other), and companies (employee assistance) along with programs for hospice, assisted living, and nursing care were developed. Each program was designed for the served venue, with modules chosen for the specific needs and expectations of participants. As appropriate, each module incorporated video introduction, didactic presentation, interactive activities, and workbooks. These programs evolved further into discussion-leader trainings and opportunities for personal growth.
Development of a Longitudinal Narrative Medicine Program for Pre-Clinical and Clinical Medical Students at The Warren Alpert Medical School of Brown University
My Columbia University Narrative Medicine Fellowship work over this past year encompassed the implementation of the principles and practice of narrative medicine into undergraduate medical education at Alpert Medical School. The objective of this project was to create, implement and evaluate an elective introducing preclinical students to the concepts and practices of narrative medicine. Our primary hypothesis was that participating students would perceive narrative medicine to be an effective means of enriching communication, patient-centered care, collaboration and professional development. The secondary hypothesis was that students would develop skills integral to medical practice, consistent with Alpert Medical School’s (AMS) “Nine Abilities” and those mandated by the Liaison Committee on Medical Education (LCME). The overarching goal was to implement a longitudinal curriculum for medical students that include seminars, workshops and clinical shadowing opportunities to explore the field of narrative medicine, after implementation of the pilot preclinical elective. Future directions include developing robust assessment and evaluation plans to measure outcomes, and expanding narrative medicine seminars to the clinical years, with sessions centered on themes relevant to the experiences of these students.
The Intima, Refreshed: The Intima was created by a group of graduate students in the Narrative Medicine program in Columbia in 2010, and published its first journal in Fall 2011. Some six issues later, it has attracted writers in the literary and medical fields from around the world. After four successful years, The Intima and its staff of 10 editors, has taken on a new challenge: To upgrade the look, navigation, and scope of its website, in addition to bolstering our social media presence. In addition to refreshing the look and function of The Intima, a portion of this fellowship grant would go toward strengthening the scope of The Intima by holding another essay contest and hosting other nights at Bowery Poetry Club.
The Narrative Medicine fellowship funds will be utilized in three areas. First, expand and complete NarrativeNursing.com. Second, to run a research study with a floor or unit of a hospital with nurses who work in areas with high rates of burnout (pediatric oncology, critical care and emergency department) to measure any fluctuations in the compassion fatigue levels of said nurses. Lastly, if the results do, indeed, help nurses and their levels of compassion fatigue, the remainder of the fellowship monies will be utilized to market NarrativeNursing.com to nurses who may be at high risk for compassion fatigue.
Does close reading lead to close listening? As practitioners of narrative medicine, we believe — and hope — that it does. I’m trying to answer that question with a brief narrative intervention in the neurology clerkship at the University of Virginia. The students will compare lay and medicalized descriptions of migraine, and then will write their own “parallel chart” on a patient they saw in clinic or in the hospital. I’m looking for differences in the writing style between those who completed a narrative medicine workshop and those who simply read the essays on their own. If our pilot program is successful, the narrative workshop will become a part of the neurology clerkship.
Anoushka Sinha & Lauren Kascak
Our project is twofold: to provide a space for patients in the Palliative Care Department of Tata Memorial Centre in Mumbai to share their stories by listening to and documenting their life histories; and to facilitate a series of Narrative Medicine workshops with palliative care staff at the hospital. We will then assess the impact of our presence and work at the hospital by co-authoring an essay that we will strive to publish in a journal and/or present at a conference. The purpose of this project is to use Narrative Medicine as a vehicle for palliative care team building, to explore Indian palliative care professionals’ attitudes towards communicating with their patients, and to allow patients to reflect and give accounts of their lives in the season of their deaths.
I am teaching an introductory narrative seminar seminar for first and second year medical students at Case Western Reserve University in Cleveland, OH. We are working together to build the narrative skills necessary to “recognize, absorb, interpret, and be moved by the stories of illness.” Students who participate in the course will be exposed to many of the fundamental principles and practices of narrative medicine. The focus of this seminar is on exploring what it means to listen and what it means to be ill. The course culminates in an narrative project where each student must place themselves in the role of a chronically ill patient who who must tell a new doctor about their specific case.