Narrative Methodology to Examine Medical Students’ Experiences of Adverse Events

Background and Objectives: Clinically significant adverse events (CSAEs; eg, the death of a patient or a medical error) affect clinicians at all levels and can include stress, guilt, and doubt about abilities. The medical student experience may be different and could impact professional identity formation. We describe the use of narrative methodology as a research tool to understand complex life events and explore important themes in medical education. Methods: Key aspects of narrative methodology are described using an example of a research study that explored medical student experiences following a CSAE. We describe what constitutes narrative methodology, how narrative methodology is situated within a constructivist worldview, approaches for collecting and analyzing narrative data, metrics of research quality, and potential limitations to this methodology. Specifically, within the example case, we demonstrate how to use a holistic analytic lens and integrate themes across multiple stories. Results: Using narrative analysis is an important methodology that medical educators can use to explore deeply complex stories. Use of a holistic analytic lens allows for comparison across multiple stories and helps understand students’ experiences as well as their impact on professional identity formation. Conclusions: Incorporating narrative analysis into the medical education researcher’s toolbox has the potential to benefit participants and health systems by formulating answers to difficult questions, and improving education and student support through centering the stories of individual participants.