The development and evaluation of an intensive training curriculum in literature and medicine for health professionals.

The project builds upon pioneering work over the last two decades in the sub-discipline of medical humanities called literature and medicine that brings narrative approaches to bear on medical practice in clinical settings. The project director is a medical doctor and literary scholar who has designed a teaching intervention called the Parallel Chart, in which medical students are asked to write about their patients and their role as caregivers in non-technical terms. A growing body of research on "narrative knowledge" in the training of medical personnel suggests that it can play a critical role in the development of more effective and insightful therapeutic relationships with patients. Over the twelve-month period of the project, eight participants from Columbia's English department, School of the Arts, and medical college meet regularly to study literary texts around five broad themes that have emerged as particularly salient to clinical practice. For example, on the theme of causality/contingency, they explore features of literary plots that suggest causal connections and painful accidents or illnesses that raise issues of randomness, contingency, and unfairness. They compare different kinds of records of illness from medical charts to works by William Faulkner, Henry James, and Franz Kafka, which depict a provisional causality in the events of disease. The participants guide the seminar discussion, for the most part, although visiting Columbia faculty also present texts or discuss their work in related areas. Concepts emerging from the seminars are pilot tested in several clinical settings: a primary care training program in internal medicine, a writing seminar in an oncology unit of Presbyterian Hospital, and clinical teaching for third-year medical students. This "teaching practicum" informs the emerging curriculum, as well as the deliberations of the seminar. Research grants that have already been secured to support on-going evaluation of Columbia's medical humanities program provide resources for measuring the impact of the new curriculum.