Family narratives, culture, and patient-centered medicine.

BACKGROUND AND OBJECTIVES As part of our family medicine clerkship seminar on the patient-physician relationship, third-year students write about an illness episode within their own families. METHODS Using a grounded research approach, we examined 260 student narratives to extract the most significant meanings. RESULTS Significant themes that emerged include the role of family members in illness episodes, specific influences resulting from the family's ethnicity or religion, experiences with socially unacceptable illnesses, experiences with death, appreciation of the moral trajectory of illness, and situations that display the fallibility and limitations of medicine. CONCLUSIONS Writing exercises can help students recognize the centrality of narrative and of cultural values in medicine so they are better able to understand their patients and provide more patient-centered medical care.