title: Clinical realism: a new literary genre and a potential tool for encouraging empathy in medical students.
abstract: BACKGROUND
  Empathy has been re-discovered as a desirable quality in doctors. A number of approaches using the medical humanities have been advocated to teach empathy to medical students. This paper describes a new approach using the medium of creative writing and a new narrative genre: clinical realism.
  
  
  METHODS
  Third year students were offered a four week long Student Selected Component (SSC) in Narrative Medicine and Creative Writing. The creative writing element included researching and creating a character with a life-changing physical disorder without making the disorder the focus of the writing. The age, gender, social circumstances and physical disorder of a character were randomly allocated to each student. The students wrote repeated assignments in the first person, writing as their character and including details of living with the disorder in all of their narratives. This article is based on the work produced by the 2013 cohort of students taking the course, and on their reflections on the process of creating their characters. Their output was analysed thematically using a constructivist approach to meaning making.
  
  
  RESULTS
  This preliminary analysis suggests that the students created convincing and detailed narratives which included rich information about living with a chronic disorder. Although the writing assignments were generic, they introduced a number of themes relating to illness, including stigma, personal identity and narrative wreckage. Some students reported that they found it difficult to relate to "their" character initially, but their empathy for the character increased as the SSC progressed.
  
  
  CONCLUSIONS
  Clinical realism combined with repeated writing exercises about the same character is a potential tool for helping to develop empathy in medical students and merits further investigation.
authors.affiliation: Clinical Lecturer Manchester Medical School, Manchester, England. P.Mcdonald@bsms.ac.uk.
authors.forename: Paula
authors.initials: P
authors.lastname: McDonald
authors.affiliation: Medical student Manchester Medical School, Manchester, England. katy.ashton@student.manchester.ac.uk.
authors.forename: Katy
authors.initials: K
authors.lastname: Ashton
authors.affiliation: Medical student Manchester Medical School, Manchester, England. Rachel.Barratt@manchester.ac.uk.
authors.forename: Rachel
authors.initials: R
authors.lastname: Barratt
authors.affiliation: Medical student Manchester Medical School, Manchester, England. simon.doyle@student.manchester.ac.uk.
authors.forename: Simon
authors.initials: S
authors.lastname: Doyle
authors.affiliation: Medical student Manchester Medical School, Manchester, England. dorrie.imeson@student.manchester.ac.uk.
authors.forename: Dorrie
authors.initials: D
authors.lastname: Imeson
authors.affiliation: Medical student Manchester Medical School, Manchester, England. amos.meir@hotmail.com.
authors.forename: Amos
authors.initials: A
authors.lastname: Meir
authors.affiliation: Medical student Manchester Medical School, Manchester, England. gregrisser@hotmail.fr.
authors.forename: Gregoire
authors.initials: G
authors.lastname: Risser
mesh_terms: D002908:Chronic Disease / Q000523:psychology; D004501:Education, Medical / Q000379:methods*; D004645:Empathy; D006801:Humans; D033262:Narration; D012649:Self Concept; D013240:Stereotyping; D013337:Students, Medical / Q000523:psychology*; D014956:Writing