Narratives in Medicine

What is Narratives in Medicine?

Narratives in Medicine recognizes that patients present to healthcare not a standard collection of signs and symptoms that are found in a textbook. The come with stories of how their lives have been disrupted by disease, and each patient has a unique illness experience. We appreciate that illness is not just a disruption of human biology, but it is as much a disruption of personal biography. This program studies how illness narratives shape both patients' and healthcare providers' perception of disease and how they respond to these perceptions.

Leadership and Expertise

Clin Asst Prof Victoria Ekstrom Sze Min is a Consultant Gastroenterologist at Singapore General Hospital, where she spearheads the Paediatric Onset Liver Disease Program. This initiative is designed to facilitate the transition of young adults from paediatric care to adult hospital settings, ensuring they receive continuous and specialised care during this crucial phase of their lives.

Currently, Clin Asst Prof Victoria Ekstrom Sze Min is advancing her expertise by pursuing a Master's in Behavioural Science at the London School of Economics (LSE). Her studies focus on the complexities of patient decision-making and the strategic use of nudges to improve healthcare outcomes. This academic pursuit complements her clinical work, enabling her to offer a comprehensive approach to patient care.

Clin Asst Prof Victoria Ekstrom Sze Min serves as the Co-Lead in Narratives in Medicine at the SingHealth Duke Medical Humanities Institute, where she is deeply passionate about using storytelling as a therapeutic tool to bridge the gap between patients and healthcare providers. She believes that understanding patients' stories fosters empathy, understanding, and healing within the medical community. Narrative medicine goes beyond artistic representation of illness stories; it is a scientific discipline that aids healthcare professionals in comprehending the experiences of individuals living with illnesses through research and clinical practice. It aims to promote an understanding of the illness context from a patient-centred viewpoint, make diagnoses based on a person's particular circumstances instead of just systematic disease descriptions. It also improves narrative communication skills and promotes self-reflection.

Clin Assoc Prof Mok Yee Hui is a senior consultant pediatric intensivist with the children’s intensive care unit (ICU) at KKH and has interests in pediatric resuscitation, use of simulation in healthcare, and narrative medicine and reflective practice in healthcare. She graduated from National University of Singapore in 2000, obtained her Masters in Paediatrics and Child Health in 2005 and completed advanced specialist training in Paediatric Medicine in 2008.

Medical education has been one of her enduring passions in her professional journey. She has initiated numerous activities to improve resuscitation and critical care competencies in paediatric healthcare providers. This included development and leadership of a paediatric emergencies simulation training programme for paediatric residents and nurses in 2007 which remains part of paediatric residency training curriculum to date, and development of advanced simulation modules for challenging scenarios in the paediatric intensive care unit such as Extra-Corporeal Membrane Oxygenation cannulation, transport of critically ill patients and more recently, resuscitation of patients with isolation precautions.

Clin Assoc Prof Mok Yee Hui has also been actively involved in curriculum development for paediatric medicine and paediatric critical care training in Singapore, as well as the development of collaborative prescribing rights for pharmacists and advanced nurse practitioners in Singapore. She was previously APD with the Singhealth Paediatric Medicine residency program (2018-2020) and is the paediatric ICU representative sitting on the Paediatric Specialist and Subspecialty Training Committee and a committee member of the National Collaborative Prescribing Programme.

In pursuit of her continued passion for cultivating future generations of healthcare professionals, she completed simulation instructor courses under the Center for Medical Simulation (Boston) and the Danish Institute for Medical Simulation (EuSim). She also completed an educational fellowship with the Academic Medicine Education Institute Singapore in 2014/2015, and the Health Profession Educator’s program with the Harvard-Macy Institute in April 2018. She has been awarded the Dean’s award for excellence in teaching, NUS (2013) and the Outstanding Faculty Award, Pediatric Residency Singhealth (2014).

As a paediatric intensivist, the early years of her career were marked by learning the technical “ropes” of the specialty with the hope that every child could be saved. With experience, she came to realize that while she could not save every child, she could provide comfort for every family’s journey in the intensive care unit, but that could only happen if there was a positive therapeutic relationship with the family. She came to understand that a therapeutic relationship occurred when families trusted the medical practitioner, and trust was built on empathy and compassion, not just scientific expertise. There was a realization that empathy was positively reinforced when patients were viewed as people with lives and stories to tell, not just diseases to treat or problems to solve.

This led to her current interest in narrative medicine and reflective practice as a means to augment the humanistic values of our profession. She began a small pilot project on reflective writing for senior residents rotated through the Children’s ICU in 2016, followed by a multi-centre education research project on reflective writing with facilitated feedback in 2018. In her role as clinical head of Children’s ICU, she also advocated for patient and family-centred care to be included as a core value for the Unit, leading to positive changes in practices of interactions with patients and families. Hearing and telling stories shape how we practice medicine and how we connect and relate to each other. She is currently undertaking a Certificate in Professional Studies in Narrative Medicine from Columbia University, and moving forward hopes to incorporate elements of narrative medicine into medical education and clinical practice.

Scope of the Program

The Narratives in Medicine program is capacity building by running trainer-the-trainer's sessions with Conversations Involving Change methodology. Several members are also pursuing the Narrative Medicine online program at Columbia University.

Clin Asst Prof Victoria Ekstrom Sze Min

MBBS, MRCO (UK)
Consultant
Singapore General Hospital

Specialty: Gastroenterology ＆ Hepatology

Clinical Interest: Gastroenterology, Hepatology, Diagnostic and Therapeutic Endoscopy, Transitional Care

Conditions Treated by this Doctor:
Abnormal Liver Function Tests, Adult Congenital Liver Disease, Colorectal Cancer Screening, Fatty Liver Diseases, Gastrooesophageal Reflux, Hepatitis B, Hepatitis C, Liver Cancer (Hepatocellular Carcinoma), Liver Cirrhosis, Liver Fibrosis, Metabolic Liver Disease, Non-alcoholic Fatty Liver Disease (NAFLD), Non-alcoholic Steatohepatitis (NASH), Portal Hypertension, Viral Hepatitis.

Clin Assoc Prof Mok Yee Hui

MBBs, MRCPCH (UK)
Head & Senior Consultant
KK Women's and Children's Hospital

Specialty: Children's Intentsive Care

Narratives in Medicine

Prof Ivy Ng

SingHealth GCEO