Collaborative reflection and discussion using the narrative medicine approach: speech acts and physician identity

Narrative medicine has become a meaningful solution to promote medical students’ professional and personal growth. However, there is a lack of study on how students benefit from the narrative medicine approach when developing identities. This study aimed to establish and implement an integrated English reading and writing curriculum based on collaborative reflection and discussion using the narrative medicine approach, exploring how students presented and constructed physician identities by performing speech acts. First-year undergraduate students majoring in clinical medicine were recruited. Collaborative reflection and discussion were conducted in the integrated course involving 14 pieces of medical-related narrative works, along with essential elements that guided the students to engage in classroom activities. In the following analysis, the qualitative analysis software NVivo was used to identify the main speech acts and their frequency to analyze students’ perception and recognition of different physician identities. Our analysis presented 33 major speech acts and revealed their frequency and characteristics, which we summarize in five interrelated physician identities. The fine-grained analysis showed how these identities were influenced by the narrative medicine approach, which provides enlightenment for supporting students to develop their professional identities. Another unique contribution of this study was to present the teaching basis and essential elements in an integrated humanistic curriculum. The results helped clarify the relationship between speech acts and physician identity and suggested that collaborative reflection and discussion using the narrative medicine approach improved the humanistic component that was in short supply in medical education through its interdisciplinary advantages, thus promoting professional identity development that can lead to higher-quality medical and emotional care.