SHM Converge Scientific Abstract ePoster Gallery-Stories Matter: Using the Power of Stories to Teach Medical Students About Structural Competency and to Address Bias in Healthcare

Pdf Summary

This project developed a narrative medicine curriculum for third-year medical students to address health disparities linked to systemic oppression and unconscious bias. The curriculum aimed to help students learn directly from patients about the social and structural factors affecting health, reflect on their own biases, center patient voices in care, and ultimately reduce bias in the electronic medical record and healthcare more broadly.<br /><br />The program was piloted at an academic medical center from June 2020 to June 2021 across nine clerkship cohorts as a required part of the Medicine Clerkship. It emphasized active engagement and reflection. Students interviewed patients about their life stories, then reflected on what they learned, especially regarding structural violence, bias, and the broader context of patients’ circumstances. Feedback from students and themes from reflection sessions were used to refine the curriculum.<br /><br />Key findings from the pilot showed that not all patients wanted to be interviewed, and some did not want their stories entered into the EMR. The project highlighted that narrative medicine is especially valuable for students because it helped them reconnect with the reasons they chose medicine during a demanding training period. Students also felt that making patient narratives visible in the EMR could strengthen relationships between patients and providers.<br /><br />The curriculum was adjusted to better prepare students for the possibility that patient stories might involve trauma, and reflection questions were refined to better focus on structural issues and bias. Overall, student feedback supported the idea that narrative training can increase awareness of unconscious provider bias.<br /><br />Future questions include whether students retain these narrative skills in other clinical settings and whether patient stories can meaningfully reduce bias in healthcare.

Asset Subtitle

Bassem Ghali

Meta Tag

Author List Bassem Ghali, Robin S. Goldman, Zhenya Krapivinsky

Category Innovations

Concept Structural Competency

Concept Patient-Centered Care

Concept Narrative Medicine

Concept Systemic Oppression

Concept Implicit Bias

Distinguished Non-Finalist

Presenter Organization University of California, San Francisco

Presenting Author Bassem Ghali

Track Education

Keywords

narrative medicine

medical education

health disparities

systemic oppression

unconscious bias

patient stories

electronic medical record

structural violence

third-year medical students

reflection

Structural Competency

Patient-Centered Care

Narrative Medicine

Systemic Oppression

Implicit Bias