Narrative medicin - A mandatory course of the Medical Education
Medical students in their 2nd semester must learn to read fiction about illness, patients, and relatives to better understand the patient as a whole human being with a life story.
In 2017, SDU was the first university in Denmark – and in the Nordic countries – to introduce a mandatory course in the medical education in Narrative Medicine. The other Danish universities have a similar course in the medical humanities, but only as an elective course. The mandatory course at SDU lasts for six weeks and it initiates the professional track "People first". This track consists of teaching Narrative Medicine (2 ECTS), Health Psychology (2 ECTS) and Professional Ethics (2 ECTS). This is supplemented by three meetings where a student goes on a home visit to a patient with a chronic illness. The track begins in the 2nd semester of the bachelor's program and ends with a free reflection assignment in the 5th semester. The initiative is primarily aimed at maintaining a view of every patient as a whole person with an often complicated life story.
In the course in Narrative Medicine, medical students are taught to read Danish fiction texts about illness, suffering, patients, and relatives – but also literary texts written by doctors about their patients. They are taught by literary researchers from the Department for the Study of Culture and the Department of Language and Communication and by medical researchers from the Department of Clinical Medicine and the Department of Health Services Research as well as the National Institute of Public Health. The basic book on the course is the anthology Enhver sygdom er en fortælling (Every illness is a narrative) (2021).
The teaching is always based on one or more fiction texts. It can be Maria Gerhardt's short prose in Transfervinde (Transfer window) (2017) about being terminally ill with breast cancer, Pablo Llambías' poems in Monte Lema (2011) about being diagnosed with "anxiety bordering on psychosis" or Caroline Albertine Minor's short story “Sorgens have” (The garden of grief) from (2017) about being a relative of a girlfriend who comes across a serious traffic accident. Through methodically conscious close reading of the texts' presentation of illness and meetings with the health system, pedagogical spaces are created for the students to become acquainted with how other people think, feel and experience illness. The close reading of the texts is discussed in small groups, and this reflection process is extended in an individual writing exercise, which can make the individual student more reflective on his or her own understanding of the given problem.
The principles and pedagogical practice of courses in "Narrative Medicine" at SDU are strongly inspired by the educational program Narrative Medicine at Columbia University in New York, which is led by Professor Rita Charon. Here, medical students are also taught close reading of and creative writing about fiction, and the effect of their teaching is gradually well documented in many studies, which is collected in systematic reviews. At other American universities and at many universities around the world, Narrative Medicine or Medical Humanities is a regular part of the medical students' curriculum. It is widely believed that a purely biomedical education of doctors is an incomplete education. Of course, the good doctor does not always have time to hear the patient's whole life story, but an awareness that every patient has such a story is a requisite for the communication and affiliation between a doctor and a patient to succeed. Exactly in this connection, the diverse and linguistically precise world of fiction can be one of several ways to cast a glance at the human factor in any meeting between a doctor and a patient or the relatives.