When serious illness occurs, effective communication is essential but challenged by language barriers. This study explores how patients with limited Danish proficiency and their families experience language barriers during cancer care in two Danish public hospitals.

Adopting a phenomenological-hermeneutic approach, the study stresses narratives in understanding participants' lived experiences. Accordingly, nine qualitative, semi-structured interviews were conducted with 17 informants, including nine patients and eight relatives. The interviews were audio-recorded and transcribed verbatim.

Based on analysis, three themes were identified: 1) A history of pain behind the language barrier; 2) Linguistic pain-a feeling of being trapped in mother tongue; and 3) Barriers and pathways to linguistic safety. The findings reveal that painful stories were not only brought into the hospital but continued there. Painful feelings associated with being unable to communicate directly with the healthcare professionals seemed inescapable, but continuity of empathetic care providers, including professional interpreters, increased the well-being of both patients and family members.

Language barriers not only make patients more susceptible to misunderstandings and medical errors but amplify experiences of pain during cancer care. The generated knowledge from this study emphasizes language as a foundational element in advancing more equitable cancer care.

Black Americans are less likely than White Americans to have advance directives, die while receiving hospice services, or have their end-of life wishes honored. The root causes of disparities include imbalance of resources, lack of trust in health care institutions, lack of adequate education regarding end-of-life options, communication differences of health care providers with black vs white patients, variable access to hospice services in different communities, and poorer pain management for Black patients compared to White patients. Because root causes are numerous, comprehensive solutions are required. When advance care planning is in place, people are more likely to choose care focused on priorities and comfort than on seeking aggressive, sometimes futile, interventions in the last weeks of life. One important component of the solution should include listening to narrative stories of Black people as they encounter life-limiting diagnoses. Gathering the stories about life events and how strength was found through adversities can be a tool for growing trusting relationships and engaging in shared decision-making. Health care professionals should invite Black patients with serious illnesses to explore the sources of their strengths and identify their core values to work toward developing directives for the nature and place of their end-of-life and help to mitigate disparities in high quality end-of-life care.

Narrative medicine has emerged over the past few decades as an exciting approach to medical practice, interweaving the practice of medicine with the practices of literary analysis and reflective writing. It is often claimed that narrative medicine enables practitioners to understand and empathize with patient stories, effectively 'joining' patients in illness. However, I argue that there are reasons to be suspicious of narrative medicine's ability to promote patient-centered care. I begin by questioning the distinctiveness of narrative knowledge, suggesting that it is neither able to be propositional knowledge ('knowledge-that') nor phenomenal/experiential knowledge ('knowledge-what-it's-like'). Then, I consider an alternative reading of narrative medicine, by which narratives are simply ways to structure patient information so that a physician can more readily empathize with the patient. I dismiss this alternative as unsatisfactory given that it depends on either all patients building narratives or physicians imposing narrative structure(s) where one does not inherently exist, thus overriding patients. Finally, I provide possible supplements and alternatives to narrative medicine, proposing that active listening and the removal of systemic barriers to physicians' abilities to provide humanistic care (e.g., lower administrative, profit, and documentation burdens) may be a first step to putting empathetic patient care on the forefront. Ultimately, I think that these efforts (while their fruition may present difficulty), rather than sifting through patient information to construct and elevate narratives, present the opportunity to accurately refocus patient-centered care.

Perspective-taking is increasingly valued as an important competence to deliver person-centered care. It is conceptualized as a facet of cognitive empathy, but also connected to other attitudes and competences. Multiple studies report on educational interventions focused on perspective-taking, but an overview of instruments to measure perspective-taking is lacking. This scoping review aims to get insight into the instruments currently used to measure perspective taking in different educational fields and healthcare settings.

A systematic search was conducted in seven databases. After screening for eligibility by multiple authors, 60 articles were included. The ascertained measurement instruments were subcategorized in psychometric instruments, qualitative methods and indirect instruments.

The psychometric scales encompassed five independent scales for perspective-taking and three subscales of multidimensional empathy scales. Predominantly self-reporting scales were found, only one scale used patient-reported assessment. The qualitative studies used semi-structured interviews, written responses and the 'think-aloud' procedure. Indirect instruments concern tools initially developed for different purposes used for measuring perspective-taking.

This scoping review provides insight into the measurement approaches of perspective-taking in different domains. However, there is a lack of independent psychometric instruments and systematic qualitative tools for perspective-taking. Future research should develop and validate novel measurement instruments for perspective-taking in healthcare education.

Suicidal behavior, encompassing both suicidal ideation and attempts, is a common symptom among individuals with depression, significantly contributing to the overall burden of the illness. This study aimed to develop a narrative nursing method based on the Three-Step Theory of Suicide and applied this method to explore its preliminary effectiveness in depression patients with suicide attempts.

50 patients with depression and high suicide ideation were randomly allocated to two groups: an intervention group, which received narrative nursing based on the Three-Step Theory of Suicide alongside usual nursing, and a control group, which received only usual nursing. The differences in depression levels, drug attitudes, and suicidal ideation were compared between the two groups both before and after the intervention. This study has been officially registered in the China Clinical Trial Registry (Registration No. ChiCTR2300079100).

A total of 50 patients were enrolled in this study, with 25 patients in the intervention group and 25 patients in the control group. 6 participants were lost to follow-up in the intervention group, and 4 participants were lost to follow-up in the control group. After the intervention, the intervention group showed significant effectiveness compared to the control group in the score of depression, drug attitude and idea of suicide.

Narrative nursing base on Three-Step Theory of Suicide could relieve depression, improve drug attitudes, thereby enhancing medication and treatment adherence, and alleviate suicidal ideation. Therefore, the method could be further applied to explore long-term effects.

[26 May 2025]: This article was published in Early View in error. The article is under embargo and will republish in December 2025.

Empathy is a key factor in the medical field as it strengthens doctor-patient relationships, enhances communication, and leads to improved patient outcomes. This study aims to investigate the empathy levels of medical students, providing insights into the factors that influence these levels and using advanced analytical methods for accurate predictions.

The study was conducted with 322 medical students from a public university in Turkey. A relational screening model was applied, using a "Personal Information Form" and an "Empathy Scale" to gather data. CHAID analysis was employed to identify the key predictors influencing empathy levels, whereas machine learning algorithms were utilized to classify and predict individuals' empathy levels.

The analysis revealed that 41.3% of students displayed high empathy, 44.7% moderate empathy, and 14.0% low empathy. Factors such as parental education, maternal occupation, and gender were significant in determining empathy levels, with gender being the most influential. The machine learning models achieved an 80.1% accuracy in predicting empathy levels.

The findings indicate that targeted educational and social interventions, especially those addressing gender differences, could improve empathy in medical students, potentially leading to better patient care.

Not applicable, as this study does not report results from a health care intervention involving human participants.

Current training models do not adequately prepare pediatricians to care for children with medical complexity (CMC) as part of a team. Narrative medicine may foster mutual understanding between clinicians and families with colearning as a foundation for collaborative care. In this study, we implemented family-led interprofessional narrative medicine training and explored participants' perspectives in complex care.

We performed a qualitative study of narrative medicine training grounded in entrustable professional activities (EPAs) in complex care. We recruited clinicians and families who care for CMC to participate in a series of 6 workshops. Each workshop involved close reading of a text and discussion related to a clinical activity in complex care. Participants defined the EPA before and after each workshop. We performed thematic analysis of EPA definitions and workshop transcripts and synthesized findings into a conceptual model.

We recruited 3 interprofessional cohorts (35 total participants) with a mean participation rate of 80%. Each cohort included at least 2 family partners. We analyzed EPA definitions and transcripts from 18 workshops across all cohorts. Four themes emerged involving shifts in perspective about complex care: fragmented to holistic care, intractable to navigable complexity, transactional to relational connection, and caring in isolation to caring in community. Findings aligned with elements of patient- and family-centered care.

Clinician and family participants in narrative medicine training described changes in their perspectives on key clinical activities in complex care. Further research should explore colearning models for pediatricians and families that foster team-based patient- and family-centered care.

To develop and validate a machine learning (ML) model to differentiate malignant from benign thyroid nodules (TNs) based on the routine data and provide diagnostic assistance for medical professionals.

A qualified panel of 1649 patients with TNs from one hospital were stratified by gender, age, free triiodothyronine (FT3), free thyroxine (FT4) and thyroid peroxidase antibody (TPOAB).

Thyroid function (TF) data of 1649 patients with TNs were collected in a single centre from January 2018 to June 2022, with a total of 273 males and 1376 females, respectively.

Seven popular ML models (Random Forest, Decision Tree, Logistic Regression (LR), K-Neighbours, Gaussian Naive Bayes, Multilayer Perception and Gradient Boosting) were developed to predict malignant and benign TNs, whose performance indicators included area under the curve (AUC), accuracy, recall, precision and F1 score.

A total of 1649 patients were enrolled in this study, with the median age of 45.15±13.41 years, and the male to female ratio was 1:5.055. In the multivariate LR analysis, statistically significant differences existed between the TNs group and thyroid cancer group in gender, age, free triiodothyronine (FT3), free thyroxine (FT4) and TPOAB. Among the seven tested ML models, the best performance was achieved in the Gradient Boosting model in terms of precision, AUC, accuracy, recall and F1 score, with the AUC of 0.82, accuracy of 79.4% and precision of 0.814 after experimental verification. FT4, TPOAB and FT3 were validated as the top three features in the Gradient Boosting model.

This study innovatively developed a predictive model for benign and malignant TNs based on the Gradient Boosting Decision Tree algorithm. For the first time, it validated the clinical predictive value of TF parameters (FT4, FT3) and TPOAB as key biomarkers.

Current literature favours individualised decision making, an approach that requires understanding patients within their context and tailoring treatment and recommendations to their unique needs. In neonatology, family context becomes synonymous with patient context. In the neonatal intensive care unit (NICU), the team may be challenged to understand the intricacies of the family context, paramount for both families and clinicians. However, a significant gap exists between the intent to share information about the family context and the process of doing so. The transformational goal of this project was to embed an understanding of the family context into all interactions that occur in the NICU between clinicians and families, and between clinicians when discussing patients.

We designed and implemented the Family Snapshot (FS), an innovation to bridge the gap between the intent and the process to share the family context.

Two groups of process measures have been collected to understand workflow integration: (1) whether the forms are being used and (2) how the forms are being used. Overall, completion of at least some part of the FS was >90%.

This manuscript describes our process, its feasibility and impact and presents two tools, the FS antenatal consultations and the FS tab.

Approximately one third of youth with chronic primary pain receiving care in a tertiary care pediatric pain setting, and their parents, report diagnostic uncertainty, which is associated with poorer child pain outcomes and is intricately tied to clinical communication along the pain care journey. This study utilized archived data (collected 2003-2006) to explore components of the clinical encounter that influence diagnostic uncertainty among youth with chronic pain and their parents. Twenty-three youth with chronic primary pain and at least one of their parents who presented for an initial visit at a tertiary pediatric pain clinic participated. Initial clinic intake visits were audio and video recorded, and youth and parents participated in semi-structured interviews prior to, and several months following, their intake appointment. Transcripts of clinical encounters and pre- and post-interviews were analyzed using interpretative phenomenological analysis. Analyses generated four themes: 1) Diagnostic uncertainty is a social phenomenon critically shaped in clinical encounters; 2) (In)validation of pain, the journey, and diagnostic uncertainty; 3) The (missing) link between origin story & pain explanation; and 4) The fragility of certainty. These themes illustrate that youth's and parents' experiences of diagnostic uncertainty are complex, dynamic, and shaped within clinical encounters. The actions taken and explanations provided by clinicians in the clinical encounter can heighten or lower diagnostic uncertainty. Clinician communication, including (in)validation, messages of (un)certainty, elicitation of youth's and parents' pain origin stories and their connection to a pain explanation, influence diagnostic uncertainty and could be targets for assessment, training, and intervention.

This paper challenges the typical function of narrative in the medical humanities to advocate for a medical posthumanities: an approach that destabilizes the centrality of "the human" and instead embraces patient narratives that are embodied, fragmented, and provisional. To make this claim, we first challenge the stability of the "humanity" described in the "medical humanities" and reiterated in the genre that we call "the medical romance." In this genre, illness and suffering destabilize a sense of identity and coherence, which is then restored through introspection and interpretation of the patient narrative. To challenge this genre, we turn to surface reading, a literary studies technique that sees traditional interpretation as too hurriedly foreclosing on meaning. Through a close reading of Franz Kafka's The Trial and Henrik Ibsen's Hedda Gabler, we demonstrate both what surface reading looks like and also how it embraces generic and interpretive instability. Finally, we focus this approach to narrative on physician-assisted suicide (PAS), particularly attending to PAS and disability, to argue that both medical romance and its entailed traditional narrative interpretation overvalue "the human" as an agential individual seeking a "good death." This at once affirms the tendency to encourage the allegedly meaningful death of disabled people by PAS, and also excludes from narrative focus the structural and environmental sources of suffering. The medical posthumanities, in its attention to embodiment, networks, environment, and the decentralizing of individual agents, would better make room for patient narratives that value the messiness and interconnectedness of lived experience.

Mastectomy, a surgical procedure involving the removal of breast tissue, is a common treatment option for breast cancer. Post treatment, survivors often experience both physical and psychological symptoms, which in turn delay the recovery phase. Post-mastectomy wound complications, such as infection, pain, delayed healing, seroma formation, persistent discomfort and limited mobility often lead to prolonged hospital stays and reduced quality of life. Proper wound care, including dressing changes and wound management, is crucial for optimal healing. However, mastectomy also has a significant emotional and psychological impact on patients, leading to depression, anxiety, and poor body image due to significant changes in the body such as loss of hair, unsightly scars and weight changes. Patients also feel uncomfortable when medical professionals concentrate solely on survival, rather than empathizing with them. While these emotional reactions are often expected and considered normal during breast cancer treatment, what comes as a surprise is the additional harm caused by healthcare providers' communication and behaviour when treating breast cancer patients. Despite advances in medical technology, there remains a significant gap in providing psychosocial support for breast cancer survivors. Undergoing a mastectomy is an emotionally challenging experience, and healthcare providers play a vital role in establishing the groundwork for psychological recuperation. By incorporating empathetic practices into daily patient care, healthcare providers can be trained to create an unbiased, informative, and compassionate environment, to improve patient outcomes and satisfaction. The use of compassionate communication when interacting with the patient and their care givers can foster a more nurturing atmosphere for all parties involved. By prioritizing empathy in post-mastectomy wound care, healthcare providers can enhance the overall well-being of breast cancer survivors. This review explores the physical and emotional impact of mastectomy on patients, the healing process, and the importance of integrating empathy into post-mastectomy wound care.

Objective: With conditions such as sexually transmitted infections and unintended pregnancies disproportionately impacting college students who identify as people with uteruses (PWUs), this qualitative study uses frameworks of narrative medicine and the socioecological model to explore diverse perspectives of PWUs toward seeking sexual and reproductive health services at the on-campus Arthur Ashe Women's Health Clinic at the University of California, Los Angeles. Participants: 151 students completed the eligibility screening survey, of whom 38 participated in the interviews. Methods: Participants were recruited via a screening survey and then purposely sampled to participate in an in-depth interview or focus group discussion. Interview transcripts were iteratively coded and analyzed. Results: Student recommendations for the clinic focused on increasing accessibility and duration of appointments, expanding price transparency, and offering post-appointment support, among others. Conclusion: This study elucidates the healthcare-seeking behaviors and attitudes of PWUs within the college context to work toward more adequate and equitable on-campus sexual and reproductive health.

The objective of this study is to incorporate narrative medicine (NM) into undergraduate orthodontics educational courses, evaluate its impact on the empathy levels and professional skills of students, and examine student feedback on the curriculum.

A cohort of 120 fifth-year undergraduate orthodontics students enrolled between June 2023 and June 2024 were selected as participants in the study and randomly assigned to the experimental and control groups. Students in the control group received training through traditional teaching methods that combined textbook content with clinical cases. Those in the experimental group received training through an NM-integrated orthodontics curriculum structured around the 5E instructional model: engagement, exploration, explanation, elaboration, and evaluation. The Chinese version of the Jefferson Scale of Physician Empathy-Student Version (JSPE-S) and the mini clinical evaluation exercise (Mini-CEX) were used to evaluate the effectiveness of the course. In addition, a self-administered questionnaire was used to collect students' feedback on the curriculum.

Upon course completion, students in the experimental group had significantly higher scores in both the JSPE-S and Mini-CEX compared with those in the control group (P<0.05). The evaluation of the NM-integrated orthodontics course by students in the experimental group was extremely positive, with the majority advocating for its continued implementation.

In this study, the integration of NM into the undergraduate orthodontics curriculum yielded positive educational outcomes, enhancing students' empathy and professional competencies by fostering a more engaging learning environment.

Chat Generation Pre-Trained Converter (ChatGPT) is a language processing model based on artificial intelligence (AI). It covers a wide range of topics, including medicine, and can provide patients with knowledge about esophageal cancer.

Based on its risk, this study aimed to assess ChatGPT's accuracy in answering patients' questions about esophageal cancer.

By referring to professional association websites, social software and the author's clinical experience, 55 questions concerned by Chinese patients and their families were generated and scored by two deputy chief physicians of esophageal cancer. The answers were: (1) comprehensive/correct, (2) incomplete/partially correct, (3) partially accurate, partially inaccurate, and (4) completely inaccurate/irrelevant. Score differences are resolved by a third reviewer.

Out of 55 questions, 24 (43.6%) of the answers provided by ChatGPT were complete and correct, 13 (23.6%) were correct but incomplete, 18 (32.7%) were partially wrong, and no answers were completely wrong. Comprehensive and correct answers were highest in the field of prevention (50 percent), while partially incorrect answers were highest in the field of treatment (77.8 percent).

ChatGPT can accurately answer the questions about the prevention and diagnosis of esophageal cancer, but it cannot accurately answer the questions about the treatment and prognosis of esophageal cancer. Further investigation and refinement of this widely used large-scale language model are needed before it can be recommended to patients with esophageal cancer, and ongoing research is still needed to verify the safety and accuracy of these tools and their medical applications.

Narrative medicine is an approach centered on patients' experiences and their illness stories. Its application in pediatric population warrants further research. This study aims to overview (1) the application of narrative medicine in pediatric medical education and (2) the implementation of narrative medicine in pediatric patient care. Searches were conducted in bibliographic databases (Cochrane Library, ClinicalTrials.gov, EBSCOhost, Embase, MedEdPORTAL, Ovid, PubMed, and Web of Science) without date or language restrictions. Researchers independently screened articles, charted data, and performed data synthesis. Educational intervention studies were evaluated with Kirkpatrick Scale, and Mixed Methods Appraisal Tool was used for methodological quality assessment of all studies. Forty-one articles met our criteria: 17 focused on the application of narrative medicine in pediatric medical education and 24 on its implementation in pediatric patient care. Educational interventions indicated general satisfaction, with reported improvements in empathy, reflection, patient understanding, and professional development. In patient care settings, narrative medicine provided a safe space for story sharing, enhancing emotional, relational, and social connections, and promoting patient- and family-centered care. This review highlights the translation of narrative medicine from educational interventions to clinical practice in pediatric settings. Although more robust research is required, existing evidence supports narrative medicine's potential to foster authentic engagement with patients and caregivers and enhance the quality of pediatric care across various conditions and developmental stages.

Healthcare providers' health humanities, empathy, and communication effectiveness positively correlate with care recipient outcomes. These abilities can be enhanced by teaching design courses. In particular, comics and community dialogues are suitable for cultivating professional students' abilities. However, this method has not yet been used in studies involving healthcare professional students.

This study develops a Comics and Interprofessional Community Dialogue (CICD) action programme for healthcare professional students to be used during emotion management courses and to evaluate the effects of this programme on changes in students' health humanities competence, empathy, and communication effectiveness. An additional aim is to determine the predictors of effective communication.

A single-group longitudinal study is conducted with professional healthcare students recruited from a medical university. The students completed three questionnaires: the Health Humanities Competence Scale, the Jefferson Scale of Empathy, and the Communication Effectiveness Profile at the beginning of the semester (Time 1), mid-semester (Time 2), and the end of the semester (Time 3). Changes in the scores for each questionnaire are analysed using generalised estimation models.

The study's findings show that at Time 3, communication effectiveness is significantly higher than at Times 1 and 2 and is positively related to empathy and health humanities competence. These results indicate that a CICD action programme improves healthcare professional students' communication effectiveness and that students' empathy and health humanities affect their communication competence.

Health humanities competence and empathy are enhanced with a CICD, which helps healthcare professional students improve their communication effectiveness. Furthermore, the semester period, empathy, and health humanities competencies are predictors of healthcare professional students' communication effectiveness competencies.

Neurotrophic keratopathy (NK) is a rare disease characterized by the loss of corneal innervation and increased vulnerability to injury. The diagnosis and treatment of NK can be challenging for pediatric patients and their caregivers. This study explores the experiences of caregivers navigating the diagnostic and treatment journey of pediatric patients with neurotrophic keratopathy.

This study is a qualitative study using semi-structured interviews.

Ten caregivers of pediatric patients with NK who had undergone corneal neurotization (CN) surgery.

Caregivers were interviewed about their experiences related to the diagnostic process, treatment challenges, lifestyle changes, and the impact of CN surgery. Interviews were recorded, transcribed, and analyzed using an inductive-deductive approach to identify recurring themes.

Caregiver experiences and perceptions of diagnostic delays, information-seeking behaviors, lifestyle changes, and the effects of CN surgery on corneal health and quality of life.

Five key themes emerged from the analysis: (1) Delays in diagnosis due to insufficient specialist knowledge; (2) Caregivers' proactive efforts in seeking information; (3) Substantial lifestyle changes required by NK; (4) The impact of CN surgery on corneal health and quality of life; and (5) Variability in healthcare experiences, highlighting the need for effective communication. Caregivers expressed frustration with diagnostic delays and highlighted their reliance on external support networks.

This study illustrates the need for enhanced awareness among clinicians about NK and the benefits of narrative medicine in fostering caregiver-provider relationships. The challenges reported by families navigating NK inform strategies that may improve diagnosis and treatment of NK.

Narrative nursing has emerged as a vital approach in patient-centered care, and emphasize the importance of understanding patients' emotional experiences in addition to their physical health needs. In this article, we comment on the article by Zhou et al. Diseases such as acute pancreatitis can cause significant suffering and severely impact patients' quality of life. During treatment, routine nursing procedures such as gastric tube placement, oxygen therapy, monitoring, and nasogastric feeding often lack effective communication, which can adversely affect patients' recovery. This article highlights how narrative nursing can provide deeper insights into patients' emotional experiences, ultimately resulting in improved care outcomes. We also emphasize the role of narrative nursing in understanding and addressing these emotional needs to achieve personalized care, which can strengthen the therapeutic relationship between healthcare providers and patients. By recognizing the critical role of emotional well-being in patient care, we can develop comprehensive strategies that facilitate recovery and enhance overall quality of life.

Narrative nursing (NN) is emerging as a critical approach in modern healthcare, addressing the complex interplay between psychological well-being and physical recovery. This manuscript discusses a study on NN and its role in alleviating psychological distress in patients with acute pancreatitis, published in the World Journal of Psychiatry. Their research demonstrates that NN, through structured storytelling, significantly reduces anxiety and depression, thereby enhancing patient satisfaction and fostering emotional resilience. This therapeutic approach extends beyond symptom management, offering a comprehensive strategy that supports the mental and emotional recovery of patients facing severe health challenges. NN provides a unique framework for engaging patients in their care journey, promoting a sense of agency, and strengthening the patient-provider relationship. In this manuscript, we explore the broader implications of NN by synthesizing findings from various studies, showing that NN is effective not only in acute settings but also in oncology, chronic illness management, and palliative care. The evidence indicates that integrating NN into standard clinical practice could enhance healthcare outcomes by addressing the holistic needs of patients, supporting psychological resilience, and fostering a compassionate healthcare environment.

Empathy for pain refers to a simulation of pain experiences evoked when seeing others in pain. Empathy for pain (vicarious pain) responders make up 27% of the healthy population, and are divided into two subsets: Sensory/Localized responders who feel localized physical pain and Affective/General responders who experience diffuse emotional pain. Empathy for pain is linked to pro-social behavior but can increase mental health symptoms.

Multivariate analysis of variance and latent variable mediation model were used to investigate the relationship between empathy for pain, mental health, and emotion regulation based on a university student dataset (mainly Caucasian) from 2020 to 2021.

(1) Responders express significantly higher anxiety and somatization than non-responders, with Sensory/Localized responders reporting the greatest somatic concerns; (2) Sensory/localized responders show significantly higher depression than non-responders; (3) Two responder groups don't differ from non-responders on most positive emotional regulation strategies, but use more negative strategies (self-blame, rumination, and catastrophizing). (4) negative emotional regulation fully mediates the link between empathy and mental health.

These findings reveal a previously unrecognized link between empathy for pain and mental health, mediated by the increased use of negative emotion regulation strategies among responders. Our findings have particular implications for the mental health of empathic individuals or people who are often exposed to the pain of others (counselor or nurse, etc.).

Facilitated poetry writing workshops are used in healthcare settings as a therapeutic approach to address stressful factors that negatively influence clinician well-being. However, owing to the novelty of this intervention and a tendency to combine poetry with other types of narrative-based techniques, proponents of poetic medicine are calling for harmonization across programs in the US. This would facilitate the study of poetry in medicine and the multiple facets of well-being it is said to promote. To address these points, we partnered with a well-established poetry center to develop and study a facilitated poetry writing workshop program for palliative care and emergency medicine clinicians during the COVID-19 pandemic.

Our qualitative aim was to describe how the workshop provided a creative outlet for the sharing and processing of clinician experiences.

We conducted a multiple-case study of six workshop sessions using transcripts, model poems, writing prompts, and participant-created poems to describe the program's structure and processes.

Our workshop contained the core components of reading, writing, and reflection; however, our program was unique in its inclusion of a website and a prewriting component. The facilitator's instruction on and fostering the use of poetic technique coupled with website interaction were key promoters of participant engagement with their peers in the processing of complex experiences and related emotions.

Healthcare systems seeking to incorporate poetry into their wellness programming may build upon our findings to create flexible workshops suited to their clinician audience and program intent.

A virtues-based model of character development for training future physicians may lead to increased flourishing in medical students through the influence of exemplary role models. This study aimed to analyze the association between caring virtues and measures of flourishing and to identify facilitators of physician flourishing.

The authors used data from a 2011 nationally representative sample of 605 US medical students in which caring virtues (mindfulness, empathic compassion, and generosity) were measured using scales at two time points during the students' clinical years. Hypothesizing a mediated influence of role models in students' generosity and flourishing, the authors explored the interrelationship between measures of mindfulness, empathic compassion, and generosity, using latent variables within a structural equation model. Built into the model were paths to determine mechanisms by which virtues and flourishing are facilitated and/or inhibited.

Analyses supported the interrelationship between physician-specific measures of mindfulness, empathic compassion, and generosity. Findings were generally consistent with the hypothesized direction of relationships between these virtues of medical care and the effect of role models on student generosity and sense of calling. Experiences of positive character feedback from a supervisor did not directly predict the generous behavior of medical students as hypothesized, but there appeared to be an indirect effect on generosity through increased vocational satisfaction. When moral elevation was added to the structural model, data offered further support for mentors inspiring caring behavior. Findings from this study provide continued evidence in support of a virtues-based model of character education in medicine that theorizes the influence of role modeling on virtues development and flourishing, including evidence for moral elevation as a potential psychological mechanism.

Medical schools may consider adopting a virtues-based model of character education in which supervisors are selected based on their capacity to exemplify virtuous care in their professional life.

Empathy is a crucial skill that enhances the quality of patient care, reduces burnout among healthcare professionals, and fosters professionalism in medical students. Clinical practice and standardized patient-based education provide opportunities to enhance empathy, but a lack of consistency and reproducibility as well as significant dependency on resources are impediments. The COVID-19 pandemic has further restricted these opportunities, highlighting the need for alternative approaches. Virtual patients through standardized scenarios ensure consistency and reproducibility while offering safe, flexible, and repetitive learning opportunities unconstrained by time or location. Empathy education using virtual patients could serve as a temporary alternative during the COVID-19 pandemic and address the limitations of traditional face-to-face learning methods. This review aims to comprehensively map existing literature on the use of virtual patients in empathy education and identify research gaps.

This scoping review will follow the Joanna Briggs Institute's guidelines and be reported according to PRISMA-P. The search strategy includes a comprehensive search across databases such as PubMed (MEDLINE), CINAHL, Web of Science, Scopus, ERIC, Google, Google Scholar, and Semantic Scholar, covering both published and gray literature without language restrictions. Both quantitative and qualitative studies will be included. Two independent researchers will screen all titles/abstracts and full texts for eligibility. Data will be extracted to summarize definitions of empathy, characteristics of virtual patient scenarios, and methods for measuring their impact on empathy development. Results will be presented in narrative and tabular formats to highlight key findings and research gaps.

As this review analyzes existing literature, ethical approval is not required. Findings will be actively disseminated through academic conferences and peer-reviewed publications, providing educators and researchers with valuable insights into the potential of virtual patients to enhance empathy in medical education. This study goes beyond the mere synthesis of academic knowledge by contributing to the advancement of medical education and clinical practice by clarifying virtual patient scenario design and evaluation methods in empathy education. The findings provide a critical foundation for our ongoing development of a medical education platform aimed at enhancing empathy through the use of virtual patients.

A first-year medical student's first patient is already dead. For decades, the cadaver, or body donor, has been the human body on which students first examine, cut, identify, and discover. That the student forms a detachment from the body and the person who once occupied the body, however, initiates a pedagogical series of events that is difficult to undo at best and may be harmful at worst. This process reveals gaps in the anatomical instruction process that present a missed opportunity to educate future physicians in a way that not only maintains their humanity and capacity for empathy but also enhances it. The anatomy lab should be a place where early medical students converse about death and begin to confront their own feelings of discomfort and hesitation. Relying on a metaphor of disappearance, as articulated by Jewson, this paper reframes this problem and offers new ways of improving human anatomy instruction through a brief examination of the history of anatomy in general, the history of the actual human being (body donor) in particular, and the response of the student through humanities-based interventions and content. In what follows, we consider the existing gaps, the possible curricular options for enhanced education, and the potential benefits of incorporating a more robust humanities curriculum in the anatomy laboratory for first-year medical students.

Concern about burnout has prompted increased attention on fostering physician resilience throughout the educational continuum. Studies indicate that lack of meaning-making and connection (domains of spiritual wellbeing) place physicians at risk for burnout. While evidence support including spiritual care in comprehensive patient care to help patients/families heal from impactful experiences, few studies explore physicians' spiritual wellbeing as they routinely confront suffering and death in their daily work. Storytelling taps into spiritual aspects of human experience. This study, unique in the literature, examined the stories physicians chose to tell about spirituality and medicine over 20-years, from trainee to practicing physician, to explore how these experiences impact professional development and wellbeing.

Design: Qualitative individual interview study - secondary analysis of a rich dataset of physician interviews, gathered over 20-years beginning in first-year residency, regarding attitudes and approach to spiritual care. For this new study, researchers extracted and analyzed the previously unexplored stories participants spontaneously told during interviews.

Participants completed the same USA residency program and now practice throughout USA and Canada.

In study-year 1, all residents (PGY1,2,3) participated; response rate (RR) 97%, reflected a diversity of personal beliefs (atheist to religious). Researchers followed the PGY1 class for 20-years (2001-2020), interviewing them in study-years 1, 3, 11 and 20 (RR 100%, 100%, 97%, 54%).

Researchers extracted stories from interview transcripts.

4 researchers analyzed 204 stories from 66 interviews with 34 physicians, using grounded theory.

Irrespective of personal spiritual beliefs, trainees and practicing physicians told numerous spirituality-related stories. Longitudinal story themes-(1) Dissonance to Integration, (2) Formation and Transformation, and (3) Accidental to Purposeful Healing - reflected physicians' ongoing spiritual journeys as they grappled with meaning, values, purpose, and connection in their daily work. Spiritually impactful moments, whether distressing or uplifting, occurred throughout physicians' careers influencing professional/personal development, resilience and clinical approach. Spiritual practices (religious/secular) and reflection fostered healing for patients/families and physicians.

Physicians' longitudinal spiritual-care stories provide new insights into their professional/personal development. Reflection on spiritually impactful moments, both distressing and uplifting, may trigger transformative learning towards meaning-making, resilience, burnout prevention and positive physician identity formation.

The growing focus on health-centered care emphasizes humanistic skills and clinical narrative competence in nursing, particularly in children's health. However, there is a lack of relevant research on pediatric nurses' clinical narrative competence and humanistic care. This study aimed to investigate the status and influencing factors of clinical narrative competence of pediatric specialist nurses.

This cross-sectional study involved 115 pediatric specialist nurses in Jiangsu province, selected through convenience sampling. The survey utilized the self-administered General Information Form for Nursing Personnel, the Clinical Narrative Competence Scale (NCS), the Nurses' Humanistic Care Quality Scale (NCCAT), and the Spiritual Climate Short-form Scale (SCS). Multiple linear regression methods were employed to analyze the factors influencing the clinical narrative competence of pediatric specialist nurses.

A total of 115 participants (all females, with a mean age of 39.07 ± 4.65 years) were involved. Total and mean NCS scores were 156.57 ± 17.42 and 5.80 ± 0.65; Total and mean NCCAT scores were 124.27 ± 12.78 and 4.29 ± 0.44; Total and mean SCS scores were 16.87 ± 2.18 and 4.22 ± 0.55. Multiple linear regression analysis indicated that the NCCAT(β = 0.440,95%CI: 0.337 ~ 0.861、P<0.001) and the SCS (β = 0.200,95%CI: 0.127 ~ 3.070, P = 0.033) were associated with NCS.

The clinical narrative competence of pediatric specialist nurses is at an intermediate level. Humanistic caring quality and spiritual climate are the influencing factors. Nursing administrators and educators should focus on improving humanistic care and work climate and adopt a personalized, multidimensional approach to enhance the education and training of pediatric specialist nurses in narrative medicine or narrative nursing, aiming to improve their clinical narrative competence.

Cognitive bias may lead to medical error and awareness of cognitive pitfalls is a potential first step to addressing the negative consequences of cognitive bias (see Part 1). For decision-making processes that occur under uncertainty, which encompass most physician decisions, a so-called "adaptive toolbox" is beneficial for good decisions. The adaptive toolbox is inclusive of broad strategies like cultural humility, emotional intelligence, and self-care that help combat implicit bias, negative consequences of affective bias, and optimize cognition. Additionally, the adaptive toolbox includes situational-specific tools such as heuristics, narratives, cognitive forcing functions, and fast and frugal trees. Such tools may mitigate against errors due to cultural, affective, and cognitive bias. Part 2 of this two-part series covers metacognition and cognitive bias in relation to broad and specific strategies aimed at better decision-making.

Narrative medicine is a recent cross-disciplinary approach which through aesthetic activities such as reading fiction and creative writing aims to encourage empathy, reflection, professionalism, and trustworthiness in the encounter between patients and health care professionals.

The aim of this study was to evaluate changes in level of empathy after a postgraduate course in narrative medicine among pharmacists conducting medication counselling.

During 2020-2021, three courses in narrative medicine among pharmacists with the aim to enhance empathy were held in Odense, Denmark. The primary outcome was the pharmacists' self-reported level of empathy before and after the course measured with Jefferson Scale of Empathy (JSE), which is a validated 20 item scale with higher scores indicating higher levels of cognitive empathy.

A total of 33 community and hospital pharmacists participated in the three courses. The pharmacists' median age was 41 years, 91% were female, 76% were working in community pharmacy, and 47% were, according to themselves, rare readers. The pharmacists completed the JSE scale before and after the course. A statistically significant increase was found in mean total JSE score from 109.9 ± 17.1 before the course to 115.7 ± 14.6 after the course (p = 0.0362).

Following the course in narrative medicine the level of empathy for the pharmacists according to JSE was enhanced. We recommend that future studies also use patient-reported outcomes to explore if the self-experienced enhanced empathy among pharmacists affects the patients' experience of their encounters.

Reflection is essential in the formation and ethical comportment of nurses. The COVID-19 pandemic brought extraordinary challenges to nursing practice and education of nurses. A pilot collaboration between a college of nursing and a department of dramatic writing at a research-intensive urban university aimed to promote the esthetic pattern of knowing through the dramatic presentation of the experiences of nursing students and frontline nurses during the height of the COVID-19 pandemic. The playwrights wrote two short plays based on interviews with two nursing students and three experienced nurses. The project sought to enhance narrative competence and empathy development of nurses and playwrights, and to promote reflection-on-action.

Medicine is recognised as a challenging course where exposure to potentially distressing content is inevitable. Some educators provide students with warnings before they encounter potentially upsetting content-trigger warnings. In this scoping review, we mapped the existing literature seeking to better understand how trigger warnings are implemented in medical schools and how they are influencing education within them.

Bibliographic databases were searched to identify relevant literature, including searching for grey literature. Articles were included if they focussed on medical school education and were written in English. Data analysis was undertaken using both quantitative and qualitative approaches (thematic analysis).

Searching generated 1284 potential records for inclusion. Articles not related to the primary research question were excluded. Abstracts of the remaining 841 articles were screened, and ultimately, 12 articles met criteria for full-text review. Of these, there were three empirical research studies. Qualitative analysis identified five main themes: purpose, implementation, student distress, responsibility and problems with terminology.

The use of trigger warnings within medical student education remains contentious. There is a lack of consensus as to their purpose and much diversity in how they are implemented. There was limited published empirical evidence to inform practice in this area.

The aim of this study was to gauge the impacts of cognitive empathy training experiential learning on traumatic brain injury (TBI) knowledge, awareness, confidence, and empathy in a pilot study of speech-language pathology graduate students.

A descriptive quasi-experimental convergent parallel mixed methods design intervention pilot study (QUAL + QUANT) was conducted with a diverse convenience sample of 19 first- and second-year speech-language pathology graduate students who engaged in a half-day TBI point-of-view simulation. The simulation was co-constructed through a participatory design with those living with TBI based on Kolb's experiential learning model and followed the recommendations for point-of-view simulation ethics. After setting goals, participants engaged in four station activities completing cognitive communication activities of daily living, while experiencing manipulations to their sensory systems. Activities included reading while wearing goggles with blurred or double vision, listening with tinnitus and auditory processing disorder, and taking notes during a manipulated college lecture. Participants also interacted with an individual living with TBI and responded to targeted prompts throughout the day. Quantitative outcomes were measured using published TBI knowledge and empathy scales and analyzed with descriptive, parametric and nonparametric statistics, while qualitative data were analyzed through thematic analysis. Data were then triangulated through mixed methods. Mixed methods design quality was ensured by following the Mixed Methods Appraisal Tool (Hong et al., 2018).

After experiential learning, significant increases in speech-language pathologist (SLP) TBI knowledge, empathy, and awareness of TBI symptom and symptom impacts were found. Many, but not all, participants also reported changes in clinical confidence.

Cognitive empathy training using experiential learning appears to be a viable method to increase SLP knowledge, empathy, and symptom awareness for TBI clinical care. Future research should replicate the study with different types and locations of speech-language pathology graduate programs to consider TBI empathy training as a standard training method to improve both individual and provider outcomes.

Individuals and families living with traumatic brain injury (TBI) say their providers lack necessary knowledge; do not seem to understand what living with TBI is like; and can be dismissive, uncaring, and lacking empathy. Health care providers do not automatically imagine the world from the patient's perspectives, to "walk in another's shoes"; it takes intentional effort and training. This project attempted to train those specific empathy skills for speech-language pathology graduate students through experiential learning. Experiential learning is a process where people engage in meaningful activities and spend lots of time reflecting on their experiences. Working with people living with TBI, we built a half-day workshop where 19 graduate students completed normal daily activities (such as texting, reading) through different stations that provided insights into what it may be like to have a TBI, such as wearing goggles to induce blurred or double vision, having ringing in their ears (tinnitus), and watching an overwhelming manipulated college video lecture. Afterward, participants listened to a person living with TBI and asked questions. This was important because engaging in activities without interacting with someone living with TBI misses a key idea about listening to and learning from individuals and families. We measured TBI knowledge, empathy, and confidence by looking at surveys pre- and posttraining and reading students' written reflections. Participants reported significant changes in how they think about brain injury and how they will provide clinical care for people living with TBI in the future.

https://doi.org/10.23641/asha.28098254.

To explore the current status of clinical nurses' narrative medicine (NM) ability and its related influencing factors, so as to provide a theoretical basis for nursing managers to develop targeted nurse training programmes.

A cross-sectional study.

A total of 1792 clinical nurses from eight medical institutions in Hunan province were selected as participants using convenience sampling.

Online questionnaires were employed to collect general data, NM competence scores, empathy ability scores and personality trait scores from the participants.

A total of 1820 questionnaires were collected, with 28 deemed invalid due to contradictory responses. The final dataset included 1792 valid questionnaires, resulting in a valid recovery rate of 98.5%.

The total NM competence score averaged at 153.37±18.34. Marital status, having children, hospital grade, empathy ability score and challenges faced in carrying out NM were identified as influential factors through multiple linear regression (p<0.01). These factors collectively explained 71.9% of the total variation in the NM competence of clinical nurses.

Clinical nurses in this study demonstrate an intermediate level of NM competence. Marital status, having children, hospital grade, empathy ability score and challenges in carrying out NM emerge as the primary factors affecting NM competence among nurses. The findings suggest that nursing managers should implement targeted measures to improve the NM competence of clinical nurses, thereby fostering their professional growth.

Individuals in the veterinary profession are experiencing significant mental health and wellbeing challenges. A holistic view of wellbeing, which encompasses both physical and mental health, underscores their interconnected nature. This integrated approach reduces the artificial separation of wellbeing facets, and highlights how mental states influence not only individuals, but also their interactions with animals, the environment, and others in the workplace. Wellbeing challenges in veterinary medicine may contribute to negative impacts in animal, human, and environmental health. Veterinary education institutions and systems are also experiencing complex challenges as they adapt to rapidly changing societal, workforce, and professional wellbeing related pressures. This review paper explores the field of positive psychology and its application in educational contexts, commonly known as positive education. A thorough exploration of the systems-informed positive education approach and ways in which it can proactively enhance veterinary professional wellbeing from within the veterinary education ecosystem are presented. It is important to recognize that individual self-care, while valuable, cannot compensate for systemic dysfunctions such as poor team dynamics, ineffective leadership, or organizational culture issues. Addressing these systemic factors is critical for creating environments that support sustained flourishing. Positive psychology interventions delivered through the pathways of individuals, groups, and organizations specifically within a veterinary education context are discussed. Limitations, considerations, and proposed measurement strategies are reviewed. The implications of implementing a systems-informed positive psychology approach to enhance wellbeing in veterinary education include creating curriculum and cultures that enable flourishing within veterinary education institutions. Strengthening the individual and collective wellbeing of veterinary professionals has the potential to enhance the quality of care provided to animals, which has myriad positive implications for animal caregivers, their communities, the environment, and society.

Medical students often struggle to engage with and retain complex pharmacology topics during their preclinical education. Traditional teaching methods can lead to passive learning and poor long-term retention of critical concepts.

This study aims to enhance the teaching of clinical pharmacology in medical school by using a multimodal generative artificial intelligence (genAI) approach to create compelling, cinematic clinical narratives (CCNs).

We transformed a standard clinical case into an engaging, interactive multimedia experience called "Shattered Slippers." This CCN used various genAI tools for content creation: GPT-4 for developing the storyline, Leonardo.ai and Stable Diffusion for generating images, Eleven Labs for creating audio narrations, and Suno for composing a theme song. The CCN integrated narrative styles and pop culture references to enhance student engagement. It was applied in teaching first-year medical students about immune system pharmacology. Student responses were assessed through the Situational Interest Survey for Multimedia and examination performance. The target audience comprised first-year medical students (n=40), with 18 responding to the Situational Interest Survey for Multimedia survey (n=18).

The study revealed a marked preference for the genAI-enhanced CCNs over traditional teaching methods. Key findings include the majority of surveyed students preferring the CCN over traditional clinical cases (14/18), as well as high average scores for triggered situational interest (mean 4.58, SD 0.53), maintained interest (mean 4.40, SD 0.53), maintained-feeling interest (mean 4.38, SD 0.51), and maintained-value interest (mean 4.42, SD 0.54). Students achieved an average score of 88% on examination questions related to the CCN material, indicating successful learning and retention. Qualitative feedback highlighted increased engagement, improved recall, and appreciation for the narrative style and pop culture references.

This study demonstrates the potential of using a multimodal genAI-driven approach to create CCNs in medical education. The "Shattered Slippers" case effectively enhanced student engagement and promoted knowledge retention in complex pharmacological topics. This innovative method suggests a novel direction for curriculum development that could improve learning outcomes and student satisfaction in medical education. Future research should explore the long-term retention of knowledge and the applicability of learned material in clinical settings, as well as the potential for broader implementation of this approach across various medical education contexts.

The adoption of the United Nations' Sustainable Development Goals (SDGs) marks a significant shift in global political agendas, emphasising sustainability in various fields, including health. To engage meaningfully with sustainability, a transformative educational approach is essential. Lange's concept of transformative learning encompasses three levels: personal and cognitive change (micro level), changes in our interactions with others and the environment (meso level) and societal changes (macro level). This paper posits that applying health humanities approaches, particularly narrative medicine, can enhance transformative education at these three levels, leading to a powerful, transformative health humanities framework for teaching sustainability and the SDGs. This interdisciplinary method, which includes reflective self-assessment, exploration of different relational perspectives and social reality comprehension, facilitates transformative learning. However, implementing this transformative strategy requires a critical reassessment of some core principles and methods within the existing health humanities paradigm.

Our previous study found that the integration of arts into the dental education through an innovative photomicrograph competition can increase the dental students' interests in learning microscopic lessons. This study aimed to validate whether the same photomicrograph competition still had its effectiveness to promote the students' interests in learning microscopic lessons.

A photomicrograph competition was organized for the 477 dental students. The students captured artistic images from the oral histology and oral pathology slides. The entries were evaluated through a peer vote. A post-competition survey was performed to assess the students' perceptions of the activity's impact on their learning interest, satisfaction, and views on the potentially broader implementation.

The photomicrograph competition gathered a 29 % overall participation rate, with the highest engagement from the third-year (66 %) and second-year (50 %) dental students. Of the participants, 73 % reported an increase in interest in the microscopic lessons, 78 % expressed satisfaction with the photomicrograph competition activity, and 80 % supported its annual continuation. Furthermore, 68 % of the students believed the photomicrograph competition could be adopted by all dental schools in Taiwan.

This study confirms the effectiveness of integrating arts into the dental education through the photomicrograph competitions. The consistent positive outcomes over time suggest the long-term viability and benefits of this approach in improving the students' histological studies, particularly among the second-year and third-year dental students. A strong support for the continued and broader implementation indicates a high potential for the incorporation of photomicrograph competitions in the dental curricula.

Black women and Black femme-identifying individuals (referred to as womxn) have developed alternative health practices that support their well-being when navigating oppressive systems. Within the U.S. healthcare system, Black womxn are disproportionally impacted by inequities and discriminatory practices, leading to higher incidences of chronic conditions, limited healthcare access, and higher mortality rates. Integrative medicine has not yet adequately examined or incorporated healing modalities practiced by Black womxn and therefore has not investigated its potential to foster more inclusive care.

This critical narrative review aims to explore the contributions of Black womxn to integrative medicine, identify components of Black feminist healing modalities, and discuss future directions for integrating these practices into integrative medicine.

A critical review was conducted using databases including PubMed, JSTOR, Taylor & Francis Online, and Sage to gather academic and praxis-focused sources. Books and films related to Black womxn healing practices were also examined. Sources were selected based on their focus on non-Western, alternative, and complementary therapies developed and practiced by Black womxn in the United States.

We identified three key categories of Black feminist healing modalities: (1) Communal Care and Communication, which includes practices like storytelling, gossip, and community gathering to foster resilience; (2) Art as a Form of Cultural Strengthening, which emphasizes the use of creative expression for healing and resistance; and (3) Spirituality. These modalities provide tools for Black womxn to resist systemic oppression and promote well-being.

Black feminist healing modalities are crucial for creating inclusive models of care that address the specific health needs of marginalized communities. Incorporating these modalities into healthcare can contribute to health equity by offering culturally relevant and holistic approaches to health for Black womxn and other historically minoritized groups. Future research should focus on developing evidence-based practices for integrating these modalities into clinical settings.

Health-related information can often be overwhelming for consumers, frequently infused with complex medical terminology that is difficult to understand and apply. Historically empathic connection, art and narratives have played key roles in communicating with diverse populations however collectively have received little recognition as a modality to improve health literacy. This study aimed to investigate the empathetic connection between art and patient narratives with a view to improve health literacy in the wider community.

Nine recently discharged patients and one carer from a regional hospital were paired with 10 tertiary visual arts students for interview. Each narrative was transformed into visual art and exhibited at a community art gallery. The Empathy Quotient (EQ), Medical Outcomes Study 36-item Short Form Health Survey (SF-36) and self-completed questionnaires assessed empathy and functional well-being. Health literacy was evaluated through community response surveys post-exhibition exposure.

Student artist participants' EQ Cognitive Empathy (EQ-CE) scores were associated with 'Emotional Reactivity' (EQ-ER) (p = .038). SF-36 scores revealed that role limitations due to physical health and emotional problems had the greatest impact on patient/carer participant's life at the time. The SF-36 General Health domain was associated with the EQ-ER total score (p = .044). Exhibition surveys revealed that 96.9% of observers had learnt something new about illness or injury. SO WHAT?: Although a relatively small study, our findings suggest patient/carer narratives and visual art is a simple yet effective modality for health service organisations to facilitate affective learning and improve health literacy when engaging with consumers.

This study aimed to expand the understanding of the patient with psoriatic arthritis (PsA) experience and to compare/contrast patient and clinician prioritization of PsA dimensions.

We conducted four patients with PsA focus groups across three US rheumatology practices using mixed methods to identify attributes of PsA important to patients. Combination with extant attributes of PsA identified by a steering committee created a comprehensive list of attributes. In separate patient and physician Delphi exercises, participants distributed 100 points across items on the list according to importance as a dimension of PsA.

Fifty-one items describing PsA were generated. Thirty-eight patients and 13 clinicians completed the last Delphi rating exercise. Patients distributed points across a wider range of items than physicians. Using group mean score per item, prioritization was compared between groups. Items with the top 10 mean scores for both groups included arthritis, disease activity, pain, fatigue, physical function, and spine symptoms. Other prioritized domains showed disparity: access to care, daily activities, stiffness, future health uncertainty, and sleep quality for patients versus specific disease skin and joint manifestations, comorbidities, structural damage, and disease management goals for clinicians.

Although concordance between patient and clinician perspectives regarding "what matters" in PsA was seen, significant areas of discordance were uncovered. Patients highlighted concerns about care access and uncertainty about the future and impact on aspects of life beyond physical symptoms, issues not usually discussed in a clinical visit. These differential prioritizations highlight opportunities for improvement in patient-clinician communications and delineate the need for more patient-centered research.

Narrative competence is essential for good communication between medical staff and patients. It is a powerful instrument for the delivery of holistic healthcare. However, little research focuses on the influencing factors of narrative competence and the relationships among resilience, self-efficacy, and narrative competence. The study aims to explore the influence factors of narrative competence of medical staff and confirm the relationships among self-efficacy, resilience, and narrative competence.

A cross-sectional survey was conducted among 606 medical staff from two affiliated hospitals in Zhejiang and Heilongjiang provinces, respectively. The participants were scored using the Chinese narrative competence scale, the brief Chinese version of the resilience scale, and the Chinese version of the self-efficacy scale.

This study showed that the score of narrative competence was 149.76 ± 28.70, including the scores of listening dimension (48.01 ± 9.36), understanding dimension (67.75 ± 13.55), and reflecting dimension (34.00 ± 6.77). A high narrative competence score was associated with hospital location and parallel chart writing (p < 0.01). Pearson's correlation analysis showed resilience and self-efficacy were positively related to narrative competence.

Medical staff's narrative competence is intermediate in China. Parallel chart writing and resilience would impact this competence, which should be further improved.

Empathy is essential in medical practice, particularly in obstetrics and gynecology. Narrative Medicine, which involves storytelling and reflective writing, has been shown to enhance empathy among healthcare providers. Despite its benefits, there is limited research on the impact of narrative medicine on empathy among obstetrics and gynecology residents.

This study is a prospective controlled trail aimed at investigating the impact of a narrative medicine-based curriculum on the empathy levels of obstetrics and gynecology residents. The subjects of this study are obstetrics and gynecology residents undergoing standardized training at Hangzhou First People's Hospital in 2023, which was divided into two groups: one receiving narrative medicine training and the other, traditional training. The Chinese version of the Jefferson Empathy Scale was used to measure empathy levels before and after the intervention. A self-developed questionnaire was distributed to Group A residents at the end of the narrative medicine course to evaluate the curriculum.

Before the intervention, there was no significant difference in empathy scores between the two groups. However, after the narrative medicine intervention, Group A showed a significant improvement in empathy scores compared to Group B (P < 0.0001). Residents in Group A also rated the narrative medicine curriculum highly, with 92% considering it "great" or "excellent"; 87% finding it effective in improving empathy and doctor-patient communication; and 91% feeling that this course promoted their self-reflection in medical practice.

The integration of narrative medicine into the training of obstetrics and gynecology residents significantly enhanced their empathy levels. Most residents perceive narrative medicine as a valued and effective means of enhancing doctor-patient communication and reflection capability.