A Year-Long Narrative Medicine Intervention to Improve Interprofessional Practice in Three Primary Care Practices
In 2015, Narrative Medicine faculty member Deepthiman Gowda was awarded a Macy Faculty Scholar, which provided funding for his 2 year duration project examining the impact of Narrative Medicine on interprofessional team functioning in primary care clinics.
Interprofessional education and practice (IPE/IPP) is central to the delivery of quality health care. Although IPE/IPP aims to improve clinical outcomes, many interventions remain outside of clinical settings. Narrative Medicine implemented in clinical settings may be a particularly effective way to enhance IPE/IPP given its focus on facilitating meaningful conversations about health care and strengthening relationships.
In March 2016, Dr. Gowda and his research team—Dorene Balmer PhD, Apurva Khedagi MS, Urmi Desai MD, Tayla Curran MS, Michael Mangold MS, and Faiz Jiwani MS—began a year-long Narrative Medicine intervention in 3 primary care clinics in New York City (family medicine, internal medicine, and pediatrics). The monthly sessions last 30-40 minutes during required interprofessional team meetings with attending physicians, residents, nurses, medical assistants, social workers and other staff.
A physician trained in narrative methods facilitates sessions while a junior colleague observes. In keeping with the Narrative Medicine model, sessions are designed to foster attention, explore representation and enhance affiliation. To that end, sessions entail discussing a text (e.g. poem, film, painting), writing reflectively in the “shadow” of that text, and sharing writing with others from a different discipline.
Qualitative data include observation notes taken during each session and semi-structured interviews with team members from different disciplines at each of the 3 clinics. Interviews are conducted at the start, mid-point, and end of the intervention. Analysis of qualitative data occurs iteratively with data collection.
To augment qualitative data, the research team administered 4 instruments to team members pre- and post-intervention to assess burnout (Maslach Burnout Inventory), engagement (Utrecht Work Engagement Scale), empathy (Interpersonal Reactivity Index), and team characteristics (Team Development Measure).
Grant Duration: July 2015 – June 2017