Narrative Medicine: an Assessment for Clinical Genetic Counseling Practice and Education

Background: Narrative medicine is an evolving approach developed by medical clinicians as a tool to strengthen patient-centered care. The framework for practice utilizes skills in "narrative competence" to counteract perceived impersonal qualities of the current healthcare system. Numerous aspects of clinical genetics practice may be particularly applicable to a narrative medicine approach. Methods: In this study, 207 genetic counselors were surveyed to examine the potential for incorporating narrative medicine methodologies into clinical genetic counseling practice and education. Results: In general, respondents indicated that demands to provide medical and genetic testing information along with time constraints were primary obstacles to developing attunement with patients. This was especially apparent in counseling specialties that utilize genetic testing technologies that have expanded significantly in recent years. Less experienced counselors were more likely to view certain internal obstacles as impediments to the provision of patient-centered care. Most counselors also reported that the relational aspects of clinical practice are one of the most important components of their work. Implications: Results from this study suggest that as genetic testing modalities change and expand, narrative medicine may be a useful tool to assist genetic counselors in sustaining a humanistic balance in a practice that is increasingly challenged to manage the demands of genetic technology. New counselors especially may benefit from training in these areas to help navigate the emotional dimensions of practice. Maintaining attention to the relational aspects of clinical work may be integral for both patient-centered care and professional satisfaction and development.