John Launer presents ‘narrative-based supervision’ (NBS) as a method for discussing complex and challenging medical cases with peers and trainees. NBS is part of a comprehensive approach to family medicine developed in the United Kingdom in the last twenty years called narrative-based primary care. Narrative-based primary care regards all conversations with patients or between professionals as collaborations for creating useful patient narratives. Almost every skill that makes for an effective patient encounter is also applicable for colleagues engaging with one another. NBS is used in one-to-one conversations with peers and learners, in small groups, and in large groups with or without facilitators. This chapter describes the origin and principles of narrative-based primary care, their application to clinical encounters, the skills involved (with numerous clinician-patient and clinician-clinician vignettes), and how these skills are used in peer supervision to improve caregiving. The companion chapter is ‘Training in Narrative-Based Supervision: Conversations Inviting Change.’
KeywordsUterine Cancer Narrative Approach Supervision Group Narrative Medicine Narrative Interview
- Bateson, G. (1972). Steps to an ecology of mind. New York: Ballantine.Google Scholar
- Berger, P., & Luckmann, T. (1966). The social construction of reality. London: Allen Lane.Google Scholar
- Bruner, J. (1990). Acts of meaning. Cambridge: Harvard University Press.Google Scholar
- Charon, R. (2001) The patient–physician relationship. Narrative medicine: a model for empathy, reflection, profession and trust. Journal of the American Medical Association, 286, 1897–902.Google Scholar
- Charon, R. (2006). Narrative medicine: Honoring the stories of illness. Oxford: Oxford University Press.Google Scholar
- Frank, A. (2001). Experiencing illness through storytelling. In S. Tooms (Ed.), Handbook of phenomenology and medicine. New York: Springer.Google Scholar
- Gabbay, J., & LeMay, A. (2010). Practice-based evidence for healthcare: Clinical mindlines. London: Routledge.Google Scholar
- Gergen, K., & Davis, K. (Eds.). (1985). The social construction of the person. New York: Springer.Google Scholar
- Gergen, K., & McNamee, S. (1992). Therapy as social construction. London: Sage.Google Scholar
- Gosling, R., & Turquet, P. (1964). The training of general practitioners. In R. Gosling, D. Miller, et al. (Eds.), The use of small groups in training. London: Codicote.Google Scholar
- Greenhalgh, T., & Hurwitz, B. (1998). Narrative-based medicine: Dialogue and discourse in clinical practice. London: BMJ Books.Google Scholar
- Halpern, H., & McKimm, J. (2010). Supervision. In J. McKimm, & T. Swanwick (Eds.), Clinical teaching made easy. London: Quay Books. http://www.faculty.londondeanery.ac.uk/e-learning/supervision/the-use-of-questions. Accessed 28 Mar 2012.
- Harre, R. (1986). The social construction of emotions. Oxford: Blackwell.Google Scholar
- Hunter, K. M. (1991). Doctors’ stories: The narrative structure of medical knowledge. Princeton: Princeton University Press.Google Scholar
- Kalitzkus, V., & Matthiessen, P. (2009). Narrative-based medicine: Potential, practice and pitfalls. The Permanente Journal 13, 80–6. http://xnet.kp.org/permanentejournal/winter09/narrativemedicine.html. Accessed 28 Mar 2012.
- Launer, J. (2002). Narrative-based primary care: A practical guide. Abingdon: Radcliffe.Google Scholar
- Launer, J., & Halpern, H. (2006). Reflective practice and clinical supervision: An approach to promoting clinical supervision among general practitioners. Work Based Learning in Primary Care, 4, 171–173.Google Scholar
- Launer, J., & Lindsey, C. (1997). Training for systemic general practice: A new approach from the Tavistock Clinic. The British Journal of General Practice: The Journal of the Royal College of General Practitioners, 47, 543–546.Google Scholar
- Launer, J., Blake, S., & Daws, D. (2005). Reflecting on reality: Psychotherapists at work in primary care. London: Karnac.Google Scholar
- London Deanery. Supervision skills for clinical teachers. http://www.faculty.londondeanery.ac.uk/supervisionskills-for-clinical-teachers. Accessed 28 Mar 2012.
- Miller, L. (2012). Medical conversations inviting change. Context, 19, 16–19.Google Scholar