Table 2

Quantitative and qualitative well-described evaluations of narrative medicine programme in systematic review*

2A. Quantitative evaluations—well described
Study	New orvalidatedoutcome	*Outcome*	Outcomes—thematicgrouping	N	Premean (SD)	Postmean (SD)	Meanchange (SD)	Pvalue
Quantitative studies reporting pretest and post-test or a control group
Bhavaraju and Miller38	New	Confidence in writing and leading writing exercises	Confidence/Personal accomplishment Pedagogical skills	12	3.1	4.2	1.1	N.R.
	New	Confidence in leading literary discussions	Confidence/Personal accomplishment Pedagogical skills	10	3.7	4.4	0.7	N.R.
	New	Integration of tools gained in training into teaching	Pedagogical skills	10	2.2	2.7	0.5	N.R.
Harrison and Chiota-McCollum85	New	Listening skills	Clinical skills	11	(Median) 4.0	(Median) 4.0	(Median) 0	N.R.
	New	Visual observation skills	Clinical skills	11	(Median) 4.0	(Median) 4.0	(Median) 0	N.R.
	New	Understanding of narrative medicine	Narrative competence	11	(Median) 3.0	(Median) 4.0	(Median) 1.0	N.R.
	New	Value of the arts in medical education	Pedagogical skills	11	(Median) 3.0	(Median) 5.0	(Median) 2.0	N.R.
Holub55	Validated	JSPE—control group	Empathy	41	119.10 (15.64)	116.15 (16.15)	−2.95 (6.77)	0.001
Holub55	Validated	JSPE—treatment group	Empathy	41	119.28 (9.05)	124.48 (8.47)	5.10 (7.20)	0.001
Rivlin and Westhoff87	Validated	Objective structured clinical examination—control group	Clinical skills	50	N/A	11.9 (1.5)	N/A	0.0049
Rivlin and Westhoff87	Validated	Objective structured clinical examination—treatment group	Clinical skills	50	N/A	11.3 (1.6)	N/A	0.0049
Winkel70 and Winkel et al22	Validated	Maslach burnout inventory: emotional exhaustion	Resilience and burnout Detection/Mitigation	43	N.R.	N.R.	−2.0 (8.7)	0.12
	Validated	Maslach burnout inventory: depersonalisation	Resilience and burnout Detection/Mitigation	43	N.R.	N.R.	0.1 (4.0)	0.61
	Validated	Maslach burnout inventory: personal accomplishment	Confidence/Personal accomplishment	43	N.R.	N.R.	1.2 (7.1)	0.70
	Validated	Interpersonal reactivity: empathic concern	Empathy	43	N.R.	N.R.	0.76 (5.9)	0.01
	Validated	Interpersonal reactivity: perspective taking	Perspective-taking/Reflection	43	N.R.	N.R.	21.37 (7.8)	0.01
Yang et al82	Validated	Jefferson Scale of Empathy—control group	Empathy	48	104.08 (12.43)	103.85 (12.00)	−0.23 (N.R.)	N.R.
	Validated	Jefferson Scale of Empathy—treatment (NM only) group	Empathy	53	104.59 (13.48)	107.57 (12.83)	2.98 (N.R.)	N.R.
	Validated	Jefferson Scale of Empathy—treatment (NM+reflective writing) group	Empathy	52	104.42 (14.11)	109.98 (13.37)	5.56 (N.R.)	P<0.05
Quantitative studies using a cross-sectional design with a post-test only
*Study*	*New or validated outcome*	*Outcome*			*Outcomes—thematic grouping*		N	*Postmean (SD)*
Goupy et al51	New	Interest of topic			Satisfaction		41	1.84 (0.82)
	New	Satisfaction with choice of theme			Satisfaction		41	2.13 (0.72)
	New	Satisfaction of discussion related to theme			Satisfaction		41	2.30 (0.62)
Whitesides et al89	New	Quality of sessions			Satisfaction		44	4.5
	New	Usefulness of writing component			Satisfaction		44	3.9
	New	Usefulness of the group discussion			Satisfaction		44	4.5
*Study*	*New or validated outcome*	*Outcome*			*Outcomes—thematic grouping*		N	*% agreement with outcome*
Gowda et al84 and Gowda et al52	New	Participant would recommend training			Satisfaction		50	94
	New	Participant would continue participating			Satisfaction		50	74
	New	Programme’s ability to facilitate interprofessional dialogue			Relationship-building		50	90
Goodrich et al49	New	Usefulness of the training			Satisfaction		48	79
Goodrich et al49	New	Interest of the training			Satisfaction		48	88
Hinyard et al77	New	Writing about own experiences helped develop communication skills			Relationship-building		24	80
Hinyard et al77	New	Listening to stories helped develop communication skills			Relationship-building		24	88
Moss et al63	New	Satisfaction of training			Satisfaction		27	99
Moss et al63	New	Relevance of training to work			Relevance to work		27	97
Walker et al69	New	Total satisfaction with course			Satisfaction		20	89
	New	Appropriateness of activities			Satisfaction		32	94
	New	Overall experience with instructors			Satisfaction		32	97
2B. Qualitative evaluations—well described†
Study	*Design*	*Timing*	*Methods*	*Outcome improved—thematic grouping*
Adamson et al74	Pretest and post-test	Pretest, immediate post-test	Interviews	Empathy Relationship-building Confidence/Personal accomplishment
Arntfield et al33	Post-test	Immediate, 1.5 years later	Open-ended surveys; focus group	Confidence/Personal accomplishment Relevance to work
Balmer and Richards37	Post-test	Immediate	Ethnography, content analysis, interviews	Institutional impact Pedagogical skills Relationship-building Perspective-taking/Reflection
Birigwa et al39	Post-test	Immediate	Surveys	Relationship-building Resilience and burnout detection/Mitigation Perspective-taking/Reflection
Bobb40	Post-test	Immediate	Ethnography, interviews	Perspective-taking/Reflection Relationship-building Confidence/Personal accomplishment
Boudreau et al41 and Liben et al42	Randomised step wedge	Immediate	Interviews	Narrative competence Satisfaction
Brigley and Jasper43	Post-test	Immediate	Observation, focus groups, interviews	Relationship-building Perspective-taking/Reflection
Chretien et al44 and Chretien et al45	Post-test	Immediate	Focus groups, patient interviews	Narrative competence Relationship-building Satisfaction
Cunningham et al76	Post-test	Immediate	Content analysis of essays	Empathy Perspective-taking/Reflection
DasGupta et al46 and DasGupta15	Post-test	Immediate	Focus groups, resident evaluations	Cultural competence Relationship-building Empathy
Goodrich et al49	Post-test	Immediate	Focus group; programme evaluation survey	Empathy Ethical inquiry Narrative competence Relationship-building
Gordon50	Post-test	Immediate	Content analysis of essays	Resilience and burnout detection/Mitigation
Goupy et al51	Post-test	Immediate	Open-ended survey	Satisfaction
Gowda et al52 and Gowda et al84	Pretest, midpoint-test and post-test	Pretest, midpoint-test, immediate post-test	Observational notes, interviews, survey	Perspective-taking/Reflection Relationship-building Satisfaction
Harrison and Chiota-McCollum85	Post-test	Immediate	Open-ended survey	Perspective-taking/Reflection Relationship-building Satisfaction
Hinyard et al77	Post-test	Immediate	Open-ended survey	Empathy Perspective-taking/Reflection Relationship-building
Holub55	Post-test	Immediate	Focus groups	Empathy
Kennedy and Sgro58	Post-test	Immediate	Open-ended survey	Satisfaction
Murrinson64	Post-test	Immediate	Content analysis of responses	Empathy Ethical inquiry Perspective-taking/Reflection
Polvani et al65	Post-test	Immediate	Patient and family interviews; video-recorded patient-doctor interactions, document review of letters of complaint	Relationship-building
Small et al90	Post-test	1.5 years later	Interviews	Relationship-building Empathy Resilience and burnout detection/Mitigation
Spike91	Post-test	Immediate	Open-ended survey	Satisfaction
Walker et al69	Post-test	Immediate	Open-ended survey	Satisfaction
Wesley et al81	Post-test	Immediate	Open-ended survey	Empathy Relationship-building Resilience and burnout detection/Mitigation
Winkel et al71	Post-test	Immediate	Questionnaire	Satisfaction
Wohlmann and Halstein72	Post-test	Immediate	Open-ended survey	Satisfaction
Zohouri et al73	Post-test	Immediate	Content analysis of essays	Empathy Relationship-building Perspective-taking/Reflection

*All quantitative evaluations—well-described report evaluation at the end of the programme except for Winkel et al and Winkel.22 70
†See online supplementary appendix 2 for outcomes/findings.
N/A, not available; N.R., not reported.