Original Publication
Open Access

Reflective Narrative Exercise

Published: October 7, 2015 | 10.15766/mep_2374-8265.10238

Included in this publication:

  • Reflective Narrative Instructor's Guide.pdf
  • Reflective Narrative Exercise.pdf

To view all publication components, extract (i.e., unzip) them from the downloaded .zip file.

Editor's Note: This publication predates our implementation of the Educational Summary Report in 2016 and thus displays a different format than newer publications.


Introduction: Facilitating growth of interpersonal communication skills and emotional empathy has received significant attention in a time when technology creates an additional barrier. In an attempt to facilitate understanding of the various perspectives involved with difficult communication events and foster emotional empathy, our program incorporates the use of a reflective narrative focused on past frustrating or overwhelming interpersonal interactions in the learners’ professional experiences during the University of Louisville’s Primary Care Education Program ambulatory rotation at the Veterans Affairs affiliate. During this rotation, residents work with behaviorally flagged veterans (as labeled by the Behavioral Risk Committee) who have a high prevalence of psychiatric disorders (e.g., depression, anxiety, post-traumatic stress disorder, anger management issues, and schizoaffective disorder). Methods: After reviewing the exercise’s instructions as a group, residents are given approximately 15 minutes to write their response to a prompt asking them to describe a difficult or uncomfortable patient interaction they have either experienced or witnessed. They are then asked to read their responses out loud to each other in groups of two or three (preferably two) and respond to each other’s stories. A short debriefing session concludes the exercise. Results: This exercise has been generally well received by learners. One participant reported having gone on to explore journaling as a means of addressing emotions throughout training; another revisited a previous love of writing poetry; still another expanded the reflective narrative and submitted it to a medical literary journal. Furthermore, learners have continued to discuss the specifics of their work with colleagues and instructors after the exercise. Discussion: This activity adds to the literature already present on reflection through (1) its primary utilization with postgraduate medical trainees; (2) its brevity and simplicity, which allow utilization by these extremely busy learners; and (3) its incorporation of reading another’s work, bringing some of the aspects of narrative medicine into the realm of reflective writing. Since this activity is a single event, it can be modified to fit into many situations. It can also be used with different levels and types of learners in health care education. Results of such an implementation outside the original context would be quite valuable. Potential collaboration with another educator at another institution is being explored, including development of a formal educational assessment.

Educational Objectives

By the end of this session, learners will be able to:

  1. Implement reflective learning through the reconsideration of events and perspectives.
  2. Provide examples of the importance of interpersonal interactions in successful patient care.
  3. Share stories of self-expression and self-examination with colleagues.
  4. Describe the role of imagination and storytelling in patient care.
  5. Contrast differences in perspectives in the discussion of specific interactions.

Author Information

  • Lori Wagner, MD: University of Louisville School of Medicine
  • Linda Roth, PhD, MEd: Wayne State University School of Medicine

None to report.

None to report.


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Wagner L, Roth L. Reflective narrative exercise. MedEdPORTAL. 2015;11:10238. https://doi.org/10.15766/mep_2374-8265.10238