Clinical narrative medicine is practiced by doctors with certain narrative abilities. The narrative ability is the ability of doctors to understand, absorb, explain, and be moved by the real story of the disease. The narrative medicine education focuses on the personality of the patient and is interested in patient experiences and stories through active listening of doctors, questions from patients, and explaining the various risk factors of treatment options and diseases to the patient in layman language. Such communication between doctors and patients makes the doctors have empathy, which increases patients' compliance and helps the medical personnel establish professional ethics and improve their humanistic quality.
The two main findings of this study were as follows. Firstly, narrative medicine teaching significantly improves the empathy ability of general practitioners, and the empathy score of conventional practitioners after narrative medical training is improved significantly compared to before teaching, which was consistent with previous findings. Especially, narrative writing training plays a positive role in the cultivation of empathy ability. This showed that the combination of narrative medicine and the traditional standardized training of residents would achieve better teaching results and enhance the medical students' technical knowledge and humanistic quality. The underlying reason may be that doctors are involved in the process of narrative medical teaching by reading narrative medicine related books and movies, expansion of medical humanities knowledge by cultivating "reading" ability, can read the "text" actively to patients, and note their families’ psychological state and emotional demands. In addition, parallel reflective writing is involved when students and patients do a role exchange, i.e., play sick to understand the perspective of patients’ problems, thereby allowing medical students to introspect and increase and achieve empathy with patients .
Secondly, students who have received narrative medicine training improved their professional knowledge performance markedly. LaRocque demonstrated that narrative medical education improves the students' performance in Objective and Structured Clinical Examinations (OSCE); the high theoretical knowledge of the study group might be due to the integration of narrative medical education into clinical practice and increased attention to patients in clinical practice. Based on the story of the patients in the clinical setting, hearing, thoughts, and parallel medical records could improve the understanding of the history and the characteristics of the disease while the doctor is in contact with the patients, improve disease diagnosis, and reduce the doctor's burnout through empathy, trust, and partnership, more willing to spend more time in medical learning.
Narrative medicine-based education is a replicable and effective teaching method, and almost all modes follow the three steps of reading, reflection, response, especially the last step, to reduce the impact of personal experience and bias on disease diagnosis by training the students' ability to deal with a large amount of clinical information.
In summary, the combination of narrative medical with standardized clinical training has better teaching results than the standard training alone. The narrative medical education can significantly improve the humanistic quality training and empathy ability of regular training doctors, thereby improving academic performance. Furthermore, narrative medicine is often patient-centered and emphasizes humane patient conditions, which not only requires relieving and even eliminating the patients' symptoms and pain but also pursues harmony and health. Thus, narrative medical education can improve the individual general practitioners' medical and humanistic literacy and enhance doctor-patient harmony. These findings indicated that narrative medicine plays a vital role in the standardized training system of resident physicians.