Poetics in Practice: Narratives of primary care consultations

The importance of narrative competence in taking/making medical case histories, modelling analytical frameworks, communicating diagnoses and treatment plans, and as a clinical teaching and research tool, is well established (Hyden 2005; Charon 2006 and 2016; Phelan 2016). This research methodology has however traditionally been applied to literary texts, rather than ‘real world’ clinical data. The One in a Million Archive consists of 300 video recordings of GP consultations with permission for reuse in research subject to ethical approval. This naturalistic data was collected from 12 Primary Care practices in Bristol between July 2014 and April 2015 and is a unique resource for studying the interactions between patients and their GPs during consultations (Jepson et al 2017). This project would enable us to apply this methodology to a corpus of ‘natural’ data for the first time, and it would be the first to use the tools of narratology to interrogate the theory and practice of narrative ‘poetics’ amongst primary care consultations, making it the first study of its kind to embrace fully this interdisciplinary challenge. By working with storyteller Daniel Morden, we can explore an experimental collaboration with arts interpretation to use our research findings to inform the co-creation of creative resources that will help to facilitate a good consultation (for both the patient and GP).

The exciting vision of this interdisciplinary project is to help inform and transform the ‘narrative competence’ of GPs, patients, and carers – and to support them towards developing better conversations during consultations. Our work will lead to a new understanding of the narrative dynamics of giving and taking patient (hi)stories and will enable the creation of creative strategies, through arts facilitation, that could help to ultimately co-create a step change in the practice of primary care consultations. This funding would allow us to test narrative methodology on a sample of naturalistic consultation data for the first time, and to then explore how this could be translated into meaningful and useful storytelling tools to improve primary care consultations.