Point-of-view writing: A method for increasing medical students' empathy, identification and expression of emotion, and insight.

CONTEXT Although interest exists among medical educators in using writing that reflects on clinical experience to enhance medical students' communication skills, empathy, and overall professionalism, little empirical research documents the value of this approach. This study explored whether students trained in one type of writing would first demonstrate increased awareness of emotional aspects of a clinical encounter in their writing; and second, be evaluated more positively in an OSCE situation by standardized patients. METHOD Ninety-two students were assigned to either a point-of-view writing or a clinical reasoning condition as part of a second year doctoring course. At the end of the year, students were evaluated in an OSCE format on 3 cases, and completed a writing assignment about an ER death from cardiac arrest. Student essays were scored according to presence or absence of various themes. A linguistic analysis of the essays was also performed. Point-of-view and clinical reasoning group scores were compared on both measures, as well as on the standardized patient OSCE ratings. RESULTS Students trained in point-of-view writing demonstrated significantly more awareness of emotional and spiritual aspects of a paper case in a writing assignment than did students trained in clinical reasoning. By contrast, students in the clinical reasoning group were more likely to distance from the scenario. The two groups did not differ on SP OSCE ratings. CONCLUSION Training in point-of-view writing can improve medical students' written skills on certain affective dimensions. It is not clear that these skills can translate into clinical behavior.