Abstract Participatory qualitative methods such as Photovoice are increasingly used to link research with social action. Recent advances in artificial intelligence (AI) may enhance data analysis, inference, and action planning within such participatory approaches. This study explored medical students’ perceptions of social justice using conventional Photovoice analysis and assessed the potential contribution of generative AI (genAI). Nine students joined a six-week seminar, “Exploring the Concept of Social Justice Using Photovoice.” An initial two-hour session covered ethics, the Photovoice framework, and photography techniques. Participants then captured images reflecting their views on social justice, wrote narratives, and engaged in guided group discussions. Human researchers and students conducted a three-stage Photovoice analysis: 1) selecting photographs, 2) contextualizing them with participant narratives, and 3) inductively coding themes. To explore how AI might support data analysis, the research team analyzed the same data with five generative tools, including Sonix, ChatGPT, and Copilot. AI-generated themes and visual representations were compared with human-derived results for congruence, depth, and suggested action steps. Conventional analysis identified five major themes: (1) Social Justice and Inequality, (2) Contradictions and the Costs of Justice, (3) Community and Collective Action, (4) Environment and Environmental Justice, and (5) Perception, Subjectivity, and Perspective. AI-assisted analysis yielded six unified themes that closely aligned with human findings. Traditional Photovoice images conveyed authentic, lived experiences and strong emotional meaning, providing a powerful foundation for advocacy. AI-generated images and thematic summaries offered efficiency, creativity, and reduced researcher bias, improving generalizability. However, they lacked the emotional depth and contextual nuance present in participant-created visuals.

Introduction:Art and humanities-based approaches have been incorporated in Diversity, Equity and Inclusion (DEI) training and anti-bias curriculum to address structural racism and personal biases via reflection. Research has shown that the use of visual art or texts via narrative medicine workshops results in improved communication with patients and colleagues and increased commitment to interrupting bias. Methods:Using members of a hospital-based Child Abuse Bias Mitigating Task Force, this study tests the hypothesis that narrative medicine workshops provide a space where conversations of race and bias in the context of child abuse evaluations can take place. Results:Workshops participants noted the unique group experience that, through sharing and communal support, helped build compassion, function more effectively as a team, and even find confidence in their own voice. Intertwined with the ability to connect with and support each other as a team was the common thread of understanding differences in perspectives and personal histories. Most participants agree that the workshops increased their ease in having conversations about privilege and bias in clinical assessment. Conclusion:We conclude that the use of art and creativity allows for personal and structural insights on racism and social advocacy with significant promise for reducing bias in child abuse evaluations.

Clinician-writers are publishing a growing corpus of personal accounts about their healthcare practices in clinical and general readership journals. For many clinician-writers, personal and creative writing offers a means for expressing both the rewards and the costs of clinical work, while providing a means to honor their patients and bear witness to their suffering. Many accounts include private, intimate moments with patients and families. Emerging at a time of consequential economic changes in healthcare systems, the inclusion of humanities, ethics, and the arts—including creative writing in medical journals—has been recognized to increase professional satisfaction and reduce burnout among physicians but also to deepen comprehension of patients’ concerns and to increase patients’ trust in their doctors. Alongside digital platforms, clinician-written essays occupy growing space in contemporary medical publishing, influencing larger public discussions about health and society. Publishing such writing creates a complex ethical dilemma regarding patient privacy and confidentiality. In this essay, we reflect on the ethical dimensions that arise when a clinician-writer considers publishing a nonfiction account that describes a patient or exposes private aspects of the writer’s self. We review the salient published literature and discuss the divergent ethical stances among clinician-writers regarding the choice to publish their writing and issues surrounding consent from patients to publish descriptions of them. An examination of journal policy guidelines reveals a paucity of attention to the particular contributions of reflective, personal, and creative writing. Instead, most journals seem to rely on informed-consent guidelines for clinical trials to guide writers of personal and creative essays in their ethical decisions. Addressing issues of privacy for patients and trustworthiness of clinicians with insights from humanities and creative disciplines can illuminate patients’ perspectives and clinicians’ creative contributions to effective care. We suggest initial concrete steps toward that aim.

New education and training opportunities are critical for the development of a diverse and highly skilled translational science workforce. In this special communication, the authors consider how Narratives of Discovery, an initiative to interview leading scientists about the sources of their creativity, can serve as a novel translational science teaching tool. Reporting on a project to map translational science principles onto nine Narratives of Discovery conducted to date, the authors demonstrate how translational science principles are manifested in the career trajectories of these scientists and propose that the narratives can serve as a formative model for trainees. Findings from systematic coding of the Narratives of Discovery suggest that the narrative format is particularly well suited to highlight translational science principles not well-addressed by existing education opportunities, including what it means for scientists to be creative and innovative, use bold and rigorous approaches, and prioritize diversity, equity, inclusion, and accessibility. Offering excerpts from the published Narratives of Discovery and quotations from the scientists themselves, the authors aim to create space for continued conversation about how to best crystallize the concepts of translational science and advance translational science education and training initiatives.

I am honored to welcome readers into this Special Issue on Narrative Medicine for the Swedish Journal of Social Medicine. We authors propose a storied conception of health care, in full view of the experiences of those who suffer illness and those who are trained to help them. Years ago, a group of clinicians and scholars at Columbia University in New York fashioned an approach to patient care that strengthened the narrative dimensions of illness and care. They named it narrative medicine. Narrative medicine invites ways of knowing from literature, history, and philosophy and creative fields of visual and performative arts into clinical practice.

Since 2018, the authors have been offering a narrative medicine training program at Centre Hospitalier Intercommunal de Créteil (CHIC). Once a month, five interprofessional groups attended a two hour-long workshop facilitated at least by a literary consultant and a health professional. This chapter will describe the three-phase model developed (basic, creative, and co-facilitated workshops), the methodology utilized, and the innovations brought about by this project. The authors used a dialogic research approach to analyze participant feedback and evaluate the effects of this narrative medicine experience. The goal with this chapter is to offer a training model that can be transferable and adaptable to other hospitals and healthcare facilities.

Despite decades of international entreaties for improvement, education about and provision of healthcare for people with disabilities remains harmfully inferior to that of the non-disabled population. Many obstacles confound efforts to ameliorate this inequity, perhaps the most pernicious of which is negative bias on the part of providers. Narrative medicine offers a means to address healthcare attitudes towards people with disabilities, in particular negative attitudes based on 'ableism'. Through absorbing, writing, and sharing of diverse perspectives, narrative medicine kindles imagination and empathy, promoting self-reflection. This approach enriches the students' capacity to absorb what their patients are trying to say, and to appreciate, respect, and hopefully meet the healthcare needs of people with disability.

Life-writing combines, collates, or colludes many lives into one text. No work of fiction, biography, poetry, drama, memoir, journaling, blogging, or autobiography—all of them life-writing—does not do this, either blatantly or surreptitiously. I am interested in forms in which authors do not own up to writing about themselves under the cover of writing about another. This essay will focus on the implications of this generic collusion in writing in health care. Health care professionals are given space within their professional journals to write personal essays about their work. Typically, these essays include a patient portrait or vignette as a means to probe some aspect of clinical practice. Some, not all, of these journals provide guidelines for protecting the privacy/confidentiality of patients described in the essay, including instructions for how to "fictionalize" patients or families to render them non-identifiable, even to themselves. A clinician-author may adopt this genre to illuminate a moment in practice that bears reflection and provides insight into the world of care. Often, however, the essay's tenor is the author, and the patient is pressed into service as but the vehicle for that examination. The genre may be adopted to confess an error, to lament a woe (generalizable to all readers), to critique the actions of colleagues or patients, or to boast of a successful clinical intervention. Perhaps these essays are all, or should all, be co-authored "duets" by patient and clinician.

ABSTRACT:In an age of police violence against Black persons and their mass incarceration, Americans seek a "public sphere" in which to examine the torn fabric of race relations. To date, efforts to overcome centuries-long polarizations and to find collective avenues toward racial justice have had little success. This essay proposes that narrative engagement and creative discovery can open paths toward mutual comprehension, if not reconciliation, in the sphere of racial justice.Focusing on racial inequity within health care, faculty from the Division of Narrative Medicine at Columbia University designed and executed an intensive three-day workshop entitled "Race | Violence | Justice: The Need for Narrative" using the methods and principles of narrative medicine. This essay provides a critical race theory conceptual framework for the project and summarizes the content and process of the workshop itself. To learn about the workshop's outcomes, the 110 participants were surveyed anonymously six months later in an unsolicited email questionnaire composed of three open-ended questions and a creative exercise. The team accomplished a modified-grounded-theory–guided content analysis of the survey question responses and a narrative/poetics reading of the responses to the creative exercise.The study identified overarching themes and revealed uniform and enthusiastic endorsement of the methods of the workshop with evidence of lasting impact on respondents' work, teaching, activism, and personal lives. Although limited by the number of participants and respondents, the study supports the necessity of narrative and creative approaches in anti-racism and anti-bias work.

Today, we are witnessing a new permeability between the arts and the sciences. Scientists are urged to promote transformative creativity in their trainees. Nobelists credit surprise and the imagination for their insights. The health professions have incorporated the humanities, social sciences, and arts into their curricula to teach relational, cultural, and creative dimensions of health care. Whether artists or scientists, investigators strike out from what is known to brave the unknown in acts of creative discovery.

Medical education is traditionally grounded in the sciences. However, there is a movement to integrate the humanities into medical education to improve the practice and wellbeing of physicians and trainees, including narrative medicine, a literary-based discipline developed in the USA to enhance medical practices by honoring the stories of patients and providers (Charon 2001). To implement this new approach, faculty development is essential. Medical educators in Taiwan were interested in narrative medicine but were not sure how to make it applicable to the local context where doctors are more authoritative than patientcentered and have limited exposure to the humanities after high school.

PURPOSE:To investigate students' experience (over time) with meta-reflection writing exercises, called Signature Reflections. These exercises were used to strengthen reflective capacity, as part of a 4-year reflective writing portfolio curriculum that builds on a recognized strategy for reflection (narrative medicine) and employs longitudinal faculty-mentors.METHOD:In 2018, the authors conducted 5 focus groups with 18 third-year students from the Columbia University Vagelos College of Physicians and Surgeons class of 2019 to examine students' experience with Signature Reflections. Using an iterative, thematic approach, they developed codes to reflect common patterns in the transcripts, distilled conceptually similar codes, and assembled the code categories into themes.RESULTS:Three core themes (safe space, narrative experience, mirror of self) and 1 overarching theme (moving through time) were identified. Students frequently experienced relief at having a safe reflective space that promoted grappling with their fears or vulnerabilities and highlighted contextual factors (e.g., trusted faculty-mentors, protected time) that fostered a safe space for reflection and exploration. They often emphasized the value of tangible documentation of their medical school journey (narrative experience) and reported using Signature Reflections to examine their emerging identity (mirror of self). Overlapping with the core themes was a deep appreciation for the temporal perspective facilitated by the Signature Reflections (moving through time).CONCLUSIONS:A longitudinal narrative medicine-based portfolio curriculum with pauses for meta-reflection allowed students, with faculty support, to observe their trajectory through medical school, explore fears and vulnerabilities, and narrate their own growth. Findings suggest that narrative medicine curricula should be required and sufficiently longitudinal to facilitate opportunities to practice the skill of writing for insight, foster relationships with faculty, and strengthen students' temporal perspectives of their development.

On a sunny day in a studio overlooking the Hudson River, a Mark Morris dancer guides a group of medical students in choreographing their patients’ stories. This class in narrative medicine provides a safe laboratory where doctors-to-be learn to view their relationships with future patients as an improvisatory partnered dance in which the choreography adjusts moment to moment as new challenges, details, and possibilities for healing emerge.

The linguistic, rhetorical, and metaphorical powers of language profoundly influence events of health care. Physicians are professionalized into their own isolating language at the cost of fluency in their native tongue. Translation is always inadequate. Physicians resort to ironizing detachment from patients to delude themselves that they will not sicken and die. David Foster Wallace’s Infinite Jest and the Wittgensteinian and enactive/embodied cognitive and phenomenological concepts that support his work offer models for clinicians committed to authentic care of patients.

On 7 May 2020, Columbia University Global Centers hosted an online international symposium on ethical dilemmas during the COVID-19 pandemic. This interdisciplinary engagement between philosophers and Covid medical professionals reports the challenges as well as the discrepancies between ethical guidelines and reality. This collection of presentations identifies four key ethical dilemmas regarding responsibility, fairness, dignity and honouring death. In looking into accountability and consistency in medical humanities, it examines whether the contextuality of coronavirus across countries and cultures affected the ethical decision-making processes. This work aims to provide a seminal resource for the development of a high-quality roadmap in medical ethics for future health crises.