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Best Practice

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Document Typology: Article
Target groups: Health Workers
country Where It Took Place: Italy
Name of compiler: tania
name of institution: cipes piemonte
role: coordinator of the project
language Of The Description: English
title: Sharing stories: Narrative medicine in an evidence-based world.
description Of The Best Practice:
Our lives are made up of stories. Stories have a direction and draw the reader into the mystery of what will happen next. Some of our earliest memories are of stories told to us at the end of the day by parents and loved ones. The practice of medicine is lived in stories. But stories do more than facilitate conversation.
Stories have an uncertain place in the world of medicine. There is an increasing push toward evidence-based thinking. The anecdote is disparaged as “soft” in contrast with “hard” clinical data. But as details of disease are pur- sued, there are details of a life that may be left behind [9]. The language of biomedical disease conflicts with the details of patient illness . Narrative fits into a broader framework, specifically as one method of reflection. Reflection includes “considera- tion of the larger context, the meaning, and the implications of an experience or action [23]” and allows the practi- tioner to integrate and re-work concepts, skills and values into their cognitive framework or understanding. Learn- ing is a cycle of action and reflection [24]. The ability to reflect has emerged as an important physician charac- teristic for professional development and for learning in the clinical setting
Quality indicators:
Use of means of narrative medicine
Writing and narrative can be seen as an act of being, paying attention and capturing details of the present moment. Writing narrative is, simultaneously, an act of observing, of becoming, of predicting, and of making choices about how one might act differently or re-write the story, our part or that of others. Yet stories have an uncertain place in the world of medicine.
Narrative probes the depths of medical experience, and allows for greater understanding of patients and work. Stories, for the writer, and often for the reader, can be the work of meaning, and even creation. This allows for great possibilities. To do its work, writing creates and recreates the past in the present moment.
Frustrated by how long it takes cutting-edge knowledge to trickle down from the lab to the doctor's office, patients have been rushing to come up with their own ways of achieving what the health care industry calls rapid learning. In October, the Institute of Medicine (IOM), an influential advisory group, hosted a rapid-learning conference at which experts discussed some of the obstacles to aggregating and applying cancer-care data in real time, including privacy issues.
Sharing data — as well as giving people full access to their digitized health records — is being championed by deBronkart, now an online activist known as "e-patient Dave." He has teamed up with Dr. Daniel Sands, the physician who helped him kick his cancer into remission in 2007, to co-chair the newly created Society for Participatory Medicine, which encourages patients to learn as much as they can about their health and also helps doctors support patients on this data-intensive quest.

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