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Volume 19, Issue 3 (2026)
J Med Edu Dev 2026, 19(3): 39-51 |
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Ethics code: IR.ARUMS.MEDICINE.REC.1402.069
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Arabzadeh A A, Salehian A, Kamran A. Narrative medicine in surgical education: a qualitative study of medical interns’ experiences. J Med Edu Dev 2026; 19 (3) :39-51
URL: http://edujournal.zums.ac.ir/article-1-2792-en.html
URL: http://edujournal.zums.ac.ir/article-1-2792-en.html
1- Department of Surgery, School of Medicine, Imam Khomeini Hospital, Ardabil University of Medical Sciences, Ardabil, Iran
2- Department of Community Medicine, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran ,akamran@arums.ac.ir
2- Department of Community Medicine, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran ,
Abstract: (264 Views)
Background & Objective: Narrative Medicine (NM) is increasingly recognized as an educational approach that promotes reflection, empathy, and the integration of theoretical knowledge with clinical practice. Although NM programs have been widely implemented in Western medical schools, empirical evidence on learners' lived experiences with such programs in developing countries, particularly in clinical settings, remains limited. This study explored medical interns' experiences with narrative-reflective writing as implemented in a surgical ward in Iran.
Materials & Methods: This qualitative process-evaluation study was conducted from 1 September 2023 to 20 June 2024. Sixteen medical interns (9 females, 7 males) participated in a three-phase NM program comprising an introductory orientation, structured narrative-reflective writing assignments based on a modified Gibbs reflective cycle, and individualized faculty feedback. Data were collected through semi-structured, in-depth interviews focusing on participants' perceptions, reactions, and immediate learning outcomes, consistent with Kirkpatrick Level 1 evaluation. Coding and categorization followed a structured codebook to ensure transparency, consistency, and analytic rigor.
Results: Analysis revealed four main themes: (1) cognitive deepening and evidence-integrated learning; (2) emotional and professional growth, encompassing confronting emotions, ethical awareness, and professional confidence; (3) movement toward patient-centered care, reflecting a more holistic perspective and an orientation toward quality improvement; and (4) structural constraints and contextual barriers, including workload, limited resources, and variable instructor support. Participants reported that NM strengthened reflective thinking, reinforced clinical reasoning, enhanced professional identity, and supported patient-centered, ethically informed care.
Conclusion: Engagement in NM supported interns' reflective capacity, professional identity formation, and critical thinking skills, contributing to both personal and professional growth. Sustained institutionalization of NM requires structured programming, adequate infrastructure, committed faculty involvement, and access to scientific resources.
Materials & Methods: This qualitative process-evaluation study was conducted from 1 September 2023 to 20 June 2024. Sixteen medical interns (9 females, 7 males) participated in a three-phase NM program comprising an introductory orientation, structured narrative-reflective writing assignments based on a modified Gibbs reflective cycle, and individualized faculty feedback. Data were collected through semi-structured, in-depth interviews focusing on participants' perceptions, reactions, and immediate learning outcomes, consistent with Kirkpatrick Level 1 evaluation. Coding and categorization followed a structured codebook to ensure transparency, consistency, and analytic rigor.
Results: Analysis revealed four main themes: (1) cognitive deepening and evidence-integrated learning; (2) emotional and professional growth, encompassing confronting emotions, ethical awareness, and professional confidence; (3) movement toward patient-centered care, reflecting a more holistic perspective and an orientation toward quality improvement; and (4) structural constraints and contextual barriers, including workload, limited resources, and variable instructor support. Participants reported that NM strengthened reflective thinking, reinforced clinical reasoning, enhanced professional identity, and supported patient-centered, ethically informed care.
Conclusion: Engagement in NM supported interns' reflective capacity, professional identity formation, and critical thinking skills, contributing to both personal and professional growth. Sustained institutionalization of NM requires structured programming, adequate infrastructure, committed faculty involvement, and access to scientific resources.
Keywords: education, medical, internship and residency, general surgery, qualitative research, reflective practice, patient-centered care, professional competence
Article Type : Orginal Research |
Subject:
Medical Education
Received: 2026/04/21 | Accepted: 2026/06/20 | Published: 2026/07/1
Received: 2026/04/21 | Accepted: 2026/06/20 | Published: 2026/07/1
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