Constructions of empathy as a professional skill in medical education fiction seminars

:speech_balloon: Speaker: Anja Rydén Gramner @anjagramner

:classical_building: Affiliation: Linköping University

Title: Constructions of empathy as a professional skill in medical education fiction seminars

Abstract: We explore the significance of narratives in medical education, focusing on quantitative and qualitative research that highlights the impact of narratives on empathy training, end-of-life care situations, and moral residue experiences (i.e., a common experience among healthcare professionals and other moral agents when they perceive their own failure to meet moral requirements, despite others’ tendency not to blame them). Four papers present research conducted with the aim of reshaping the use of narrative in medical education. They describe the impact of fiction and nonfiction-labeled literary narratives, various types of narrative engagement, first-person narratives, fiction seminars, and transformative reading interventions.


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:newspaper: Long abstract
Within the medical profession, empathy is a professional skill connected to increased patient satisfaction and greater quality of care (e.g., Derksen et al., 2013). Empathy is also seen as a central aspect of professional identity development in medical education (Zhou et al., 2021). Meanwhile, despite focused pedagogical efforts, studies have shown that medical students’ empathy declines during their education (Sulzer et al., 2016). Fiction seminars have been used for professional development with the aim of supporting medical students’ empathy and self-knowledge. However, the potential for empathy development through fiction seminars has previously not been studied from a classroom perspective.
The aim of this paper is to investigate medical students’ and tutors’ constructions of empathy as a professional skill, using discursive psychology (Edwards & Potter, 1992) to analyse 38 video-recorded fiction seminars from two medical schools. Empathy is here defined through the way participants of interaction themselves use the term, and it is understood not as a mirror of inner experience but rather as a socially constructed phenomenon, deployed for social action such as accountability, assessment and affiliation (Edwards, 1999).
Tentative results show that students and tutors use fictional characters and events as case studies where empathy is constructed either as an inner experience or as an observable behaviour, and as either an inherent trait or a learnable skill. These different constructions of empathy are challenged and negotiated in interaction, creating potentials as well as obstacles for empathy development and learning.

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Thanks so much for your paper, Anja. It touches on several issues that are also on the minds of our Moral Residue team, as you know, and I’d really love to have a chat sometime during or after the conference to learn more from your experiences finding your way into the world of medical education—we’re hoping to run intervention studies in that area as well.

You mentioned that students responded positively to the seminars. I’m curious—do you have any sense of whether they appreciated these sessions more than comparable seminars that don’t use fiction? And related to that, I’d be very interested in what your data might reveal about the specific value of fiction. For instance, how does it compare to using real case studies? Does the fictionality of the material perhaps offer a freer or safer space for reflection?

Thank you so much for your kind comment! I would love to chat some more about these interesting topics, I think we have many shared research interests and your work with the Moral Residue team is fascinating, so would love to hear more about that. Perhaps we can find a time for a zoom meeting some time after the conference?

Hello Anya,
I have just listened to your extremely interesting paper on empathy in medical students/ professionals and was fascinated by the students who thought you could “fake” empathy.
I have worked as a G.P. In Dublin for over forty years and I can assure you that patients know if the doctor is not really listening or faking empathy . They know 100 per cent of the time as they are vulnerable and hypersensitive .
I am also a writer and teacher of Narrative Medicine and about to commence a Masters in Creative Writing in University College Dublin in September.
I would love to keep in contact on this topic .
I also found the paper on moral Residue very interesting .
I will be in Stockholm at the end of July and would love to meet if that were possible?
Thanks again for your paper .
Nuala o Farrell
Email drnualaofarrell@gmail.com

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Dear Nuala,

thanks so much for your comment and your kind words! Yes, it is very interesting how students separate between the inner experience of empathy, and “empathetic behaviour”, as though they are two different things. Would love to talk more! My work e-mail is anja.gramner@liu.se, maybe we can talk over zoom sometime?

My very best,
Anja