title: Close Reading and Creative Writing in Clinical Education: Teaching Attention, Representation, and Affiliation.
abstract: Medical educators increasingly have embraced literary and narrative means of pedagogy, such as the use of learning portfolios, reading works of literature, reflective writing, and creative writing, to teach interpersonal and reflective aspects of medicine. Outcomes studies of such pedagogies support the hypotheses that narrative training can deepen the clinician's attention to a patient and can help to establish the clinician's affiliation with patients, colleagues, teachers, and the self. In this article, the authors propose that creative writing in particular is useful in the making of the physician. Of the conceptual frameworks that explain why narrative training is helpful for clinicians, the authors focus on aesthetic theories to articulate the mechanisms through which creative and reflective writing may have dividends in medical training. These theories propose that accurate perception requires representation and that representation requires reception, providing a rationale for teaching clinicians and trainees how to represent what they perceive in their clinical work and how to read one another's writings. The authors then describe the narrative pedagogy used at the College of Physicians and Surgeons of Columbia University. Because faculty must read what their students write, they receive robust training in close reading. From this training emerged the Reading Guide for Reflective Writing, which has been useful to clinicians as they develop their skills as close readers. This institution-wide effort to teach close reading and creative writing aims to equip students and faculty with the prerequisites to provide attentive, empathic clinical care.
authors.affiliation: R. Charon is professor, Department of Medicine, and executive director, Program in Narrative Medicine, College of Physicians and Surgeons of Columbia University, New York, New York. N. Hermann is creative director, Program in Narrative Medicine, College of Physicians and Surgeons of Columbia University, and adjunct faculty, Master of Science in Narrative Medicine Program, Columbia University School of Continuing Education, New York, New York. M.J. Devlin is professor, Department of Psychiatry, and codirector, Foundations of Clinical Medicine, College of Physicians and Surgeons of Columbia University, New York, New York.
authors.forename: Rita
authors.initials: R
authors.lastname: Charon
authors.forename: Nellie
authors.initials: N
authors.lastname: Hermann
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Devlin
mesh_terms: D001288:Attention; D003479:Curriculum; D004501:Education, Medical; D004645:Empathy; D006801:Humans; D033262:Narration; D011932:Reading; D014956:Writing