The Power of Storytelling in Medical Education (Part 1)

During last week’s Alliance Industry Summit, the primary theme of the keynote address was the power of storytelling as an educational tool. While there was far too much table interaction for my liking that really made me squirm (if you know Derek and I, you know how much we looove being forced to participate with strangers on any creative task), I did appreciate the general thrust of the session. Storytelling, you see, is one of the thing I am most passionate about both professionally and personally. If you are a faithful reader of this blog — and if you aren’t, shame on you — you hopefully have learned a lot about CMEpalooza and our personalities through our stories (or perhaps you have a poster of the CMEslinger on your wall and can’t wait for his return in 2026 for another adventure).

Think about a memorable conversation you recently had with a friend, family member, or colleague. Most of our “How were your day?” conversations may end with “Fine” or “Mid” (especially if you live with a teenager), but any time that question elicits anything memorable, it usually involves a “let me tell you a story about this interesting/funny/embarrassing thing that happened to me today.” We can’t often relate to being lectured about topics to which we have little or no personal connection, but it’s easy to relate to a well-told story from crazy Aunt Martha.

In the sessions we develop for CMEpalooza, the accredited education that I oversee as part of my “real” job, and even the historic tours I lead around Philadelphia every summer, storytelling plays a primary role. I am a big fan of using various forms of case studies within accredited education because of their storytelling capabilities and applicability to the real world. Really, the typical patient-provider encounter is just a story broken down into various elements.

I’ll illustrate how in a moment, but first, a quick story (of course)…

Last night, I was somewhat ironically helping my 14-year-old son prepare for an English quiz that focused on the five plot elements of Freytag’s pyramid. If you aren’t familiar with Freytag’s pyramid (and if you are, you must be a big English nerd), it essentially breaks down any story into five crucial elements. Allow me to align these with your typical patient-provider visit:

Element 1: The Exposition. This is basically the background of the story – who are the main characters, how do they relate to each other, where are things taking place, etc. Within a medical case study perspective, this introduces the patient and gives us some background into their family and medical history, their current medications, and so on — basically, everything within their initial chart presentation.

Element 2: Rising Action. This is the part of the story where the action starts to heat up. Often, it’s where our “hero” meets the “villain,” or in literary terms, where the protagonist meets the antagonist. While you may commonly picture the antagonist as a person or being (ie, The Joker or your mother-in-law), this isn’t always the case. In a medical case study, the antagonist is typically health, pain, or something like that. As the rising action phase emerges in our case studies, we find out what’s wrong with the patient (why are they here?) and perhaps get details from a physical exam, lab results, imaging, etc.

Element 3: Climax. This is the turning point of the story, where the protagonist and antagonist collide in a series of events that lead to either their success or downfall. In a medical case study, this is where the (hopefully) shared decision is made regarding what should be done to help cure the patient, alleviate their pain, and get them back to a healthier state.

Element 4: Falling Action. This is where the climax comes to an end and prepares us for the conclusion. It’s where the antagonist lays in a heap with their last breaths after being vanquished by our swashbuckling hero. Or, in our medical case study, the patient and clinician cement their agreement on the best plan of action and go their separate ways.

Element 5: Resolution/denouement. This is where we typically get our happy ending (or not). So for our medical case studies, the resolution is when the patient always, absolutely, positively gets better. Or maybe they don’t. Depending on the complexity of our case, the story arc may now bring us back to element 2 where the patient returns with a new complaint/issue that needs addressing. Life isn’t a fairy tale, after all.

I was going to write more today about a related theme from last week’s conference (celebrating our failures), but since this blog is already plenty long enough and you surely have work to do today, I’ll leave you in suspense for another day soon.

So for now, may you enjoy many happily ever afters…