Narrative has the function of reshaping, representing, and structuring the human language in a text. It is composed of experiences, values, and ways of inhabiting, seeing and thinking about the world. Once these human experiences and actions are encompassed in the narrative, its reading and interpretation can be used to explore social, economic and cultural conditions. The interpretation of the text also allows researchers to evaluate students’ ability to organize their actions and experiences in the narrative, expressing the signs, rules, and norms that direct their lives [14,17, 29]. Thus, the fragments of lived stories, the interaction with other people in circumstances of illness or good health, and the consequent happy or unhappy feelings facilitate their reflections on the medical humanities and help them construct their narratives.
The use of narratives in medical training was described as a strategy to develop critical thinking and to discuss several aspects of practice lived or observed by the students [8, 17, 18, 21, 30, 31]. It is a stimulus to reflect on the practice in medical training and an opportunity to apply the reflection pedagogy of Paulo Freire; this was a constructivist method based on a sequence of action-reflection-action. This means that after the learner gains experience, the teacher gives him or her the opportunity to think about those experiences and to reframe them. The next step for the student is to return to the practice field and find a way to do better [3, 31, 32].
Other learning objectives related to the use of narratives are to develop communication skills, empathy, and professionalism and to access the student's feelings [22,33]. The student's narratives can also be used to evaluate the program and the hidden curriculum and for the teacher to better get to know the students . The use of narratives in medical training helps students to consider the medical humanities in the context of their patients and access their own emotions [17, 34, 35].
Many aspects of contemporaneity were present in the student's narratives based on the idea of transforming the environment and the society in which they live, as observed in their answers to some of the contemporary issues, such as crises involving the healthcare field and extreme social inequalities. The latter is important, especially for developing countries such as Brazil. For these students, the possibility of transforming their lives and society was one of their reasons for choosing a medical career, as we have shown in a previous study .
The narratives of this study demonstrated that students establish relationships between humanism and sensitivity toward the cultural aspects of each patient. The students said that it is necessary to listen to patients; to learn about their history, culture, habits; and to be willing to help them. They also showed humanistic values when they attributed value in healthcare to human relationships and commitment to human happiness.
The effects of technical and scientific advances can be clearly seen in modern medicine when, at times, such advances separate physical, psychological, social and cultural aspects. Some authors affirm that physicians and medical students give more importance to scientific rationality than to the social, cultural, and psychological dimensions of understanding the patient and his or her disease [3, 14, 37]. The construction of a humanized relationship between healthcare professionals and patients requires ethical behavior, dialogue, and feedback. In this context, it is possible to fuse their horizons, as each human being involved is considered, valued, and potentiated, as suggested by Gadamer .
The students in this study demonstrated an understanding of the social and cultural constructs present in the personal lives of human beings, including both doctors and patients, and how these constructs interfere with the relationships between them. Interestingly, the participants were young people in their first week of medical school. They entered medical school with values inherent to their future profession, but the medical program will add complexity and sometimes cause these values to change [11, 39–42].
Humanism for these students is related to "doing" and "how to do" in medical practice, including ethical, cultural and professional dimensions. They also recognize that technical and scientific knowledge is linked to ethical behavior, which is aimed at human development and commitment to the lives and happiness of others.
The strengths of this study lie in the use of narratives with undergraduates to promote student reflection, to create a baseline for their self-concept and values, and to help the faculty to get to know the freshmen better; the results can help in educational planning. Another strength is to bring about new perspectives of humanization to medical education. A weakness of the study is the fact that the vision presented by the students is a snapshot of the moment and the social context at the time of data collection. The analysis and conclusions are valid for this universe of medical students, and the generalization of the findings is not possible.