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Alex Wright arw116@ic.ac.uk Care Opinion A MedED LECTURESession structure Assignment recap Narrative selection & analysis Topic selection & discussion Reflection Essay tips Q&A Assignment recap Narrative selection from Care Opinion website based around a theme Narrative analysis Link narratives to a HPL topic (& back again) Reflection Assignment recap Narrative selection from Care Opinion website based around a theme Narrative analysis Link narratives to a HPL topic (& back again) Reflection 3500 words by 18 November Assignment recap Narrative selection from Care Opinion website based around a theme Narrative analysis Link narratives to a HPL topic (& back again) Reflection 3500 words by 18 November What is a narrative? “apersonal narrative is a distinct form of communication: It is meaning making through the shaping of experience; a way of understanding one’s own or other’sactions; of organising events, objects, feelings, or thoughts in relation to each other; ofconnectingand seeing the consequencesof actions, events, feelings, or thoughts over time (in the past, present, and/or future)” S. (eds.). The SAGE Handbook of Qualitative Research.5th edition. USA, SAGE Publications. pp. 546-560.& Lincoln, Y. Why narratives? Meaningful Multi-layered Nuanced Connection with a reader Memorable & powerful Individual Completely subjective Greenhalgh, T. (2016) Cultural contexts of health: the use of narrative research in the health sector.Health Evidence Network (HEN) synthesis report 49. Copenhagen, WHO: Regional Office for Europe. Choosing your narratives & topic Narratives • Similar or different? • Length? • Number? • Overriding message? • Links between them? Choosing your narratives & topic Narratives Topic • Similar or different? • Search based on interests • Length? • Refine based on narratives • Number? • Overriding message? • Links between them? Choosing your narratives & topic Narratives Topic • Similar or different? • Search based on interests • Length? • Refine based on narratives • Number? • Overriding message? • Links between them? Analysing your narratives Three elements: • Plot-based • Linguistic • Functional ~Mishler Analysing your narratives Three elements: Sociological domains: • Plot-based • Nature or purpose • The making • Linguistic • The consuming • Functional • The power-plays in the story • The wider impacts ~Mishler ~Plummer Analysing your narratives Sociological domains: Three elements: • Plot-based • Nature or purpose • The making • Linguistic • The consuming • Functional • The power-plays in the story • The wider impacts ~Mishler ~Plummer Typology. Journal of Narrative and Life History.5 (2), 87- 123. Other suggestions: change, and social worlds. London, Routledge.essman, C. K. (2008) Narrative Methods for the Human Sciences. USA, Sage Publications. E.g . "Frustrated and disappointed" bathroom and come back to a consultant who told me I shouldn’t have left because they wants to scan me. When doing theto the scan they tell me my pain is on my right side. I say it is the left side, not the right, but am told no, it is the right side and I have a small harmless cyst that’s on the right. I said again that the pain is on the left but am told that they have been doing this 30 years and I need to trust them. I responded that I have been in this body for 30 years you’ll need to trust me when I say it’s the left side. I was then told that it was it was nothing serious and to go home take paracetamol. I’ve been dealing with this pain for 8 days now on pain relief far stronger with no luck, and it is getting worse so I asked for a second opinion. This was refused. I was told that they have been doing this for a long time and they know their stuff. I said it isn’t acceptable, being told where my pain is and is not, and that I’m not actually in pain just a little discomfort and suggesting I am exaggerating. Then being refused a second opinion which I believe to be illegal in the UK. I was told that if I desperately needed to stay in then I could but they weren't going to do anything and I’d be sent home tomorrow. I said I’d like to stay in and see the morning round doctor, a second opinion. I found their bedside manner atrocious and the practice old fashioned and seemingly from training 30+ years ago. I am so disappointed. I said I felt like I came in and was being sent home with the same problem and I was being dismissed. They laughed and that is hurting!exaggerating the pain on my right side. It is not sore on my right side- there is no pain there - it is my left side I am so frustrated and disappointed with this tonight. https://www.careopinion.org.uk/992499 E.g. Plot points: • Scene-setting – ‘the ward’ • Left vs right • Time • Focus on the qualities of the pain • Characters • Told in relation to self • Summary at the end • Emotion in title & conclusion https://www.careopinion.org.uk/992499 Plot "Frustrated and disappointed" bathroom and come back to a consultantwho told me I shouldn’t have left because they wants to scan me. When doing theto the scan they tell me my pain is on my right side. I say it is the left side, not the right, but am told no, it is the right side and I have a small harmless cyst that’s on the right. I said again that the pain is on the left but am told that they have been doing this 30 years and I need to trust them. I responded that I have been in this body for 30 yearsyou’ll need to trust me when I say it’s the left side. I was then told that it was it was nothing serious and to go home take paracetamol. I’ve been dealing with this pain for 8 days now on pain relief far stronger with no luck, and it is getting worse so I asked for a second opinion. This was refused. I was told that they have been doing this for a long time and they know their stuff. I said it isn’t acceptable, being told where my pain is and is not, and that I’m not actually in pain just a little discomfort and suggesting I am exaggerating. Then being refused a second opinion which I believe to be illegal in the UK. I was told that if I desperately needed to stay in then I could but they weren't going to do anything and I’d be sent home tomorrow. I said I’d like to stay in and see the morning round doctor, a second opinion. I found their bedside manner atrocious and the practice old fashioned and seemingly from training 30+ years ago. I amso disappointed. I said I felt like I came in and was being sent home with the same problem and I was being dismissed. They laughed and that is hurting!exaggerating the pain on my right side. It is not sore on my right side- there is no pain there - it is my left side I am so frustrated and disappointed with this tonight. https://www.careopinion.org.uk/992499 E.g. Plot points: Linguistic points: • Scene-setting – ‘the • Sense of rushing, then ward’ abrupt stops • Left vs right • – still in the midstnt • Time • Focus on the qualities of • Direct conflict in phrases the pain • Repetition • Characters • Passive voice– powerless, unheard • Told in relation to self • Summary at the end • Ownership in pain • Emotion in title & • Re-iterating emotions conclusion https://www.careopinion.org.uk/992499 E.g. Plot points: Linguistic points: Functionalpoints: • Scene-setting – ‘the • Sense of rushing, then • Shared on Care Opinion ward’ abrupt stops UK • Left vs right • – still in the midstnt • back to the hospital?g • Time • Focus on the qualities of • Direct conflict in phrases • Speaking to other the pain • Repetition service users • Characters • Passive voice– • Also seen by educators powerless, unheard & students • Told in relation to self • A sense of • Summary at the end • Ownership in pain powerlessness in the • Emotion in title & • Re-iterating emotions test – sharing story to conclusion reclaim the experience? https://www.careopinion.org.uk/992499 Discussion • Interpretation informing theory, theory informing interpretation • Identify themes within your analyses that build into your chosen topic • Explore the literature • Link the narratives & wider reading into your themes • Point, Evidence, Explain, Link E.g . Phenomenology of acute pain Emotion: • Hurt & frustration • Interweaved throughout • Conflicts seem to exacerbate • Relaying to reader https://www.careopinion.org.uk/992499 E.g. Phenomenology of acute pain Emotion: • Hurt & frustration • Interweaved throughout • Conflicts seem to exacerbate • Relaying to reader Time: • Specifics of time • Shifts from past to present tense – disorientation? • Still a sense of ‘in the midst’ https://www.careopinion.org.uk/992499 E.g. Phenomenology of acute pain Emotion: Lacking shared meaning: • Hurt & frustration • Left vs right • Using ‘classic’ characteristics of pain but • Interweaved throughout told from own experience – ‘my pain’ • Conflicts seem to exacerbate • Finding a shared meaning with the reader? • Relaying to reader Time: • Specifics of time • disorientation?t to present tense – • Still a sense of ‘in the midst’ https://www.careopinion.org.uk/992499 E.g. Phenomenology of acute pain Emotion: Lacking shared meaning: • Hurt & frustration • Left vs right • Interweaved throughout • Using ‘classic’ characteristics of pain but told from own experience – ‘my pain’ • Conflicts seem to exacerbate • Finding a shared meaning with the reader? • Relaying to reader Time: Powerlessness & invalidation: • Medical learning vs lived experience– contrasts • Specifics of time • Sense of relentlessness in the telling • Shifts from past to present tense – • Passive voice– loss of power disorientation? • Forming meanin– reclaiming their experience? • Still a sense of ‘in the midst’ https://www.careopinion.org.uk/992499 Where next? • Select 2-3 other narratives à analyse & build on themes • Wider reading • Philosophers – Havi Carel, Sartre etc. • Other expressions of pain – Deborah Padfield’s pain photos, poetry etc. • Medicine’s perspective on pain • Definitions of pain • Use narratives to guide the reading, inform understanding & take the reading back to the narrativesReflection How did your position influence your interpretation of the narratives? What have you learned in this process?Essay tips Plan before writing Strong introduction – scope, purpose & structure of the essay Introduce & justify your topic & methods Point, Evidence, Explain, Link Each sentence & paragraph should flow, building into your overall point Reference as you go along Don’t worry about the word count at first Finish draft early – read through, edit & ask others to check grammar & sense-making Do: • Trust your judgement, but be critical • Start early & take your time • Justify your topic, methods & choice of narratives • Use a range of analytical styles – linguistic, plot-based & functional • each other understanding using the narratives & wider reading – and use these to build on • Consistent reflection • Plan before you start writing • Take care of yourself • Be patient • Talk to each other & ask for help if you need Pitfalls • Over-interpretation • Over-objectivity • Making assumptions • Comparing to others • Struggling in silence • Procrastination! • Second-hand referencing – read what you cite! GOOD LUCK & THANK YOU FOR COMING! PLEASE FILL IN THE FEEDBACK FORM! Any questions? arw116@ic.ac.uk