Narrative and Medicine Project – John Launer

Conversations Inviting Change: A Narrative Approach to Clinical Supervision and Reflective Practice.
John Launer

DatE: November 14, 2011 | 17h00
Venue: Centro de Saúde de Sete Rios
Organization: ULICES / CFL / CHL / CBAS

“Conversations inviting change” is a UK training project aimed at embedding ideas and skills from narrative medicine into clinical practice and professional development. The project and its training methods embody the idea of narration as a creative dialogue, capable of generating both technical decisions and affective resolutions to clinical dilemmas. Based originally on concepts drawn from family therapy, the project has grown over several years from a short course for family physicians into a five-tier system of training for clinical teachers from all medical specialities. We use narrative medicine as a framework for teaching skills in attentiveness and reflectiveness, as well as self-and situational awareness. In addition to theoretical reading and formal teaching, much of the work takes place through intensive coaching in small groups. These provide opportunities for course members to have one-to-one peer supervision on clinical cases and workplace issues, with a trained coach present to invite observations on the narrative process and to make teaching points. The project now reaches several hundred hospital and primary care physicians in London every year. Evaluation has shown how participants apply their learning to clinical encounters, conversations with peers and trainees, and their personal lives. A typical response is that the training liberates them from the role of ‘Dr Fixit’ by imparting skills for sharing power in professional conversations, and helping them to achieve the resolution of clinical or educational problems through the medium of narrative and dialogue.