We examine how illness narratives are used in medical education and their implications for clinicians’ thinking and care of patients. Ideally, collecting and reading illness narratives can enhance clinicians’ sensitivity and contextual thinking. And yet these narratives have become part of institutionalizing cultural competency requirements in ways that tend to favor standardization. Stereotyping and reductionistic thinking can result from these pedagogic approaches and obscure structural inequities. We ask how we might best teach and read illness narratives to fulfill the ethical obligations of listening and asking more informative clinical interview questions that can better meet the needs of patients and the community.
Introduction
Illness narratives are a genre wherein an illness and its effect on the patient’s life are told as an autobiographical or biographical account. As Kleinman [1] and Frank [2] have argued, illness narratives are forms of meaning making. They provide insight into how patients and clinicians understand the why and how of illness causation and treatment, including how illness processes are linked to the broader social and structural contexts of patients, their communities, and their clinicians. As a form of meaning making, illness narratives can be created in a clinical encounter, wherein physicians and patients co-construct a therapeutic agenda [1, 3, 4] that weaves together what the patient and the clinician know about the illness and its context.
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