Harnessing storytelling with medical students and community members to build curiosity and trust: A mixed methods evaluation of a pilot intervention

Abstract

Background: Mistrust of medical providers disproportionately affects individuals from racialized communities. Mistrust of providers negatively influences willingness to seek care, which exacerbates health disparities. Patient-centered communication can mitigate this mistrust.

Objective: To assess the impact of a three-hour pilot workshop entitled Storytelling to Build Medical Trust, which brings medical students and Black, Indigenous and other People of Color (BIPOC) community members together to practice the skills underlying patient-centered communication, on medical student patient-centered communication self-efficacy and community member trust.

Methods: Medical students completed the Self-Efficacy in Patient-Centeredness Questionnaire (SEPCQ-27) before, after, and one-month post-participation in the workshop, while community members completed two sub-scales of the Collaboration Trust Scale at the same time points. Community members also participated in focus group discussions approximately one week after workshop completion. Focus group transcripts were analyzed using the Social Cognitive Theory.

Results: Median medical student SEPCQ-27 score increased 18 % pre to post-workshop (p < 0.001). Similarly, median scores of the Collaboration Trust Survey sub-scales "Trust in Communication" and "Trust in Partner Investment and Community Well-Being" increased 23.3 % (p = 0.025), and 18.75 % (p = 0.013), respectively. Analysis of focus group discussions identified five themes: 1) The workshop cultivated an open and comfortable environment; 2) Community members desire additional information and direction prior to the program; 3) Training medical students may have a downstream impact, but there is a pressing need to train current providers; 4) The workshop articulates opportunities for community members to assert their strength and empowers them to pursue them; and 5) Dismantling medical mistrust requires ongoing efforts.

Conclusion: The Storytelling workshop may build trust between patients from historically marginalized communities and medical practitioners.

Innovation: This is the first evaluation of a trust-building intervention that brings both medical providers and potential patients together in one room.

Keywords: Health equity; Historically marginalized communities; Mixed methods; Patient-centered communication; Trust.

Fig. 1

Study participants in final analyses.