Can literary reading and writing improve pharmacists’ medication counselling? A feasibility study of pharmacists’ efforts to achieve competence in narrative medicine


  • Trine Graabæk University of Southern Denmark, Odense, Denmark
  • Anders Juhl Rasmussen University of Southern Denmark, Odense, Denmark
  • Anne-Marie Mai University of Southern Denmark, Odense, Denmark
  • Charlotte Rossing Danish College of Pharmacy Practice, Hillerød, Denmark
  • Ulla Hedegaard University of Southern Denmark, Odense, Denmark



Community pharmacy, Feasibility study, Hospital pharmacy, Narrative medicine, Postgraduate education


Background: Narrative medicine is an innovative approach where empathetic skills are nurtured through close reading of literary texts and creative writing. The aim of this study was to evaluate the feasibility of a course in narrative medicine for pharmacists. 

Methods: A 2-day course of narrative medicine was offered to community and hospital pharmacists. Feasibility was assessed using focus group interviews, participant observation, and a questionnaire. Pharmacists’ self-reported level of empathy was also assessed.    

Results: Eight pharmacists participated in the course. They found participation acceptable, even though some of the sessions required a personal investment far from their routines. The pharmacists were generally satisfied with the course and found it helpful in their daily patient communication. There was no significant change in the pharmacists’ level of empathy.   

Conclusion: A course in narrative medicine has the potential to improve pharmacist communication with patients but needs further testing, including patient-reported outcomes.

Author Biographies

Trine Graabæk, University of Southern Denmark, Odense, Denmark

Clinical Pharmacology, Pharmacy, and Environmental Medicine, Department of Public Health

Anders Juhl Rasmussen, University of Southern Denmark, Odense, Denmark

Department for the Study of Culture

Anne-Marie Mai, University of Southern Denmark, Odense, Denmark

Department for the Study of Culture

Charlotte Rossing, Danish College of Pharmacy Practice, Hillerød, Denmark

Department of Research and Development, Pharmakon

Ulla Hedegaard, University of Southern Denmark, Odense, Denmark

Clinical Pharmacology, Pharmacy, and Environmental Medicine, Department of Public Health


Abrahamsen, B., Burghle, A. H., & Rossing, C. (2020). Pharmaceutical care services available in Danish community pharmacies. International Journal of Clinical Pharmacy, 42(2), 315–320.

Adamson, K., Sengsavang, S., Charise, A., Wall, S., Kinross, L., & Balkaran, M. (2018). Narrative Training as a Method to Promote Nursing Empathy Within a Pediatric Rehabilitation Setting. Journal of pediatric nursing, 42, e2–e9.

Akinyelure, O. P., Colvin, C. L., Sterling, M. R., Safford, M. M., Muntner, P., Colantonio, L. D., & Kern, L. M. (2022). Frailty, gaps in care coordination, and preventable adverse events. BMC Geriatrics, 22(1), 476.

Bowen, D. J., Kreuter, M., Spring, B., Cofta-Woerpel, L., Linnan, L., Weiner, D., Bakken, S., Kaplan, C. P., Squiers, L., Fabrizio, C., & Fernandez, M. (2009). How we design feasibility studies. American Journal of Preventive Medicine, 36(5), 452–457.

Brigley, S., & Jasper, M. (2010). Evaluation of a multidisciplinary faculty to support learning in surgical practice. Journal of Interprofessional Care, 24(4), 401–411.

Burghle, A., Hansen, R. N., Nørgaard, L. S., Hedegaard, U., Bendixen, S., Søndergaard, L., Servilieri, K., Hansen, J., & Rossing, C. (2021). The Danish Network for Community Pharmacy Practice Research and Development. Pharmacy (Basel, Switzerland), 9(2), 114.

Charon, R. (2001). The patient-physician relationship. Narrative medicine: A model for empathy, reflection, profession, and trust. JAMA, 286(15), 1897–1902.

Charon, R. (2008). Narrative medicine: Honoring the stories of illness (1. paperback ed). Oxford Univ. Press

Charon, R. (2013). Narrative medicine in the international education of physicians. Presse medicale (Paris, Franc : 1983), 42(1), 3–5.

Chevalier, B. A. M., Watson, B. M., Barras, M. A., & Cottrell, W. N. (2018). Hospital pharmacists’ and patients’ views about what constitutes effective communication between pharmacists and patients. The International Journal of Pharmacy Practice, 26(5), 450–457.

Coleman, D., & Willis, D. S. (2015). Reflective writing: The student nurse’s perspective on reflective writing and poetry writing. Nurse Education Today, 35(7), 906–911.

Collins, K. L., Zweber, A., & Irwin, A. N. (2017). Impact of a fictional reading intervention on empathy development in student pharmacists. Currents in Pharmacy Teaching & Learning, 9(3), 498–503.

Derksen, F., Bensing, J., & Lagro-Janssen, A. (2013). Effectiveness of empathy in general practice: A systematic review. The British Journal of General Practice: The Journal of the Royal College of General Practitioners, 63(606), e76-84.

Druedahl, L. C., Mølby Hansen, J., Freese, E. L., Almarsdóttir, A. B., & Traulsen, J. M. (2019). Mandatory medication content in the curricula of six health care personnel types with patient contact in Denmark. Basic & Clinical Pharmacology & Toxicology, 124(4), 431–438.

El-Souri, M., Nørgaard Hansen, R., Raagaard, A. M., Søndergaard, B., & Rossing, C. (2020). Pharmacy Technicians’ Contribution to Counselling at Community Pharmacies in Denmark. Pharmacy (Basel, Switzerland), 8(1), 48.

Fosgerau, C. F., Husted, G. R., Clemmensen, N. B., Rossing, C. V., & Kaae, S. (2021). Using qualitative methods to explore the dynamics of patients’ perspective sharing in community pharmacy counseling–conversation analysis and video-stimulated recall interviews. Pharmacy Practice, 19(4), 2582–2582.

Fosgerau, C. F., & Kaae, S. (2021). Furthering patient-centered counseling: Exploring new aspects around pharmacists’ experiences in pharmacy encounters through video-stimulated recall interviewing. Research in Social & Administrative Pharmacy: RSAP, 17(4), 723–732.

Giardina, T. D., Royse, K. E., Khanna, A., Haskell, H., Hallisy, J., Southwick, F., & Singh, H. (2020). Health Care Provider Factors Associated with Patient-Reported Adverse Events and Harm. Joint Commission Journal on Quality and Patient Safety, 46(5), 282–290.

Giorgi, A. (2005). The Phenomenological Movement and Research in the Human Sciences. Nursing Science Quarterly, 18(1), 75–82.

Gowda, D., Curran, T., Khedagi, A., Mangold, M., Jiwani, F., Desai, U., Charon, R., & Balmer, D. (2019). Implementing an interprofessional narrative medicine program in academic clinics: Feasibility and program evaluation. Perspectives on Medical Education, 8(1), 52–59.

Gull, S. E., O’Flynn, R., & Hunter, J. Y. L. (2002). Creative writing workshops for medical education: Learning from a pilot study with hospital staff. Medical Humanities, 28(2), 102–104.

Hojat, M., Mangione, S., Nasca, T. J., Cohen, M. J. M., Gonnella, J. S., Erdmann, J. B., Veloski, J., & Magee, M. (2001). The Jefferson Scale of Physician Empathy: Development and Preliminary Psychometric Data. Educational and Psychological Measurement, 61(2), 349–365.

Humphries, C., Jaganathan, S., Panniyammakal, J., Singh, S., Dorairaj, P., Price, M., Gill, P., Greenfield, S., Lilford, R., & Manaseki-Holland, S. (2020). Investigating discharge communication for chronic disease patients in three hospitals in India. PloS One, 15(4), e0230438.

Kaae, S., Dam, P., & Rossing, C. (2016). Evaluation of a pharmacy service helping patients to get a good start in taking their new medications for chronic diseases. Research in Social & Administrative Pharmacy: RSAP, 12(3), 486–495.

Kaae, S., Mygind, A., & Saleem, S. (2013). A characterization of the current communication patterns in Danish community pharmacies—An observational study. Research in Social & Administrative Pharmacy: RSAP, 9(6), 958–964.

Kaae, S., Nørgaard, L. S., Sporrong, S. K., Almarsdottir, A. B., Kofoed, M., Daysh, R. F., & Jowkar, N. (2019). Patients’, Pharmacy Staff Members’, and Pharmacy Researchers’ Perceptions of Central Elements in Prescription Encounters at the Pharmacy Counter. Pharmacy (Basel, Switzerland), 7(3).

Kim, M. G., Lee, N. E., & Sohn, H. S. (2020). Gap between patient expectation and perception during pharmacist-patient communication at community pharmacy. International Journal of Clinical Pharmacy, 42(2), 677–684.

Koster, E. S., van Meeteren, M. M., van Dijk, M., van de Bemt, B. J. F., Ensing, H. T., Bouvy, M. L., Blom, L., & van Dijk, L. (2015). Patient-provider interaction during medication encounters: A study in outpatient pharmacies in the Netherlands. Patient Education and Counseling, 98(7), 843–848.

Kvarnström, K., Westerholm, A., Airaksinen, M., & Liira, H. (2021). Factors Contributing to Medication Adherence in Patients with a Chronic Condition: A Scoping Review of Qualitative Research. Pharmaceutics, 13(7), 1100.

Lau, E. T., Tan, S. H., Antwertinger, Y. J., Hall, T., & Nissen, L. M. (2019). Counseling interactions between patients living with persistent pain and pharmacists in Australia: Are we on the same page? Journal of Pain Research, 12, 2441–2455.

Mai A., (ed.), Simonsen P. (ed). (2018). Syg litteratur: Litterære tekster om sygdom og sundhedsvæsen. 2 udg. Munksgaard 2018.

Malterud, K. (2012). Systematic text condensation: A strategy for qualitative analysis. Scandinavian Journal of Public Health, 40(8), 795–805.

Milota, M. M., van Thiel, G., & van Delden, J. J. M. (2019). Narrative medicine as a medical education tool: A systematic review. Medical Teacher, 41(7), 802–810.

Morton, K., Pattison, H., Langley, C., & Powell, R. (2015). A qualitative study of English community pharmacists’ experiences of providing lifestyle advice to patients with cardiovascular disease. Research in Social & Administrative Pharmacy: RSAP, 11(1), e17-29.

Moudatsou, M., Stavropoulou, A., Philalithis, A., & Koukouli, S. (2020). The Role of Empathy in Health and Social Care Professionals. Healthcare (Basel, Switzerland), 8(1), E26.

Naß, J., Banerjee, M., Efferth, T., & Wohlmann, A. (2016). Pharmaceutical care as narrative practice? Rethinking patient-centered care through a pharmacist’s perspective. International Journal of Clinical Pharmacy, 38(6), 1346–1349.

Nass, J., Efferth, T., & Wohlmann, A. (2019). Interviews and personal stories: A humanities approach in pharmaceutical education. Pharmacy Education, 19(1), 155–161.

Ng, Y. K., Shah, N. M., Loong, L. S., Pee, L. T., & Chong, W. W. (2020). Patient-centred care in the context of pharmacy consultations: A qualitative study with patients and pharmacists in Malaysia. Journal of Evaluation in Clinical Practice, 26(6), 1638–1647.

Pedersen, A. F., Ingeman, M. L., & Vedsted, P. (2018). Empathy, burn-out and the use of gut feeling: A cross-sectional survey of Danish general practitioners. BMJ Open, 8(2), e020007.

Polvani, S., Mammucari, M., Zuppiroli, A., B, F., ini, Milli, M., Fioretto, L., Sarmiento, I., Biondi, F., Trentanove, F., Santucci, L., Mechi, T., Sarti, A., Rosselli, M., Matera, M., & Giarelli, G. (2014). Narrative medicine, a model of clinical governance: The experience of the Local Health Authority of Florence in Italy. Clinical Practice, 11(5), 493.

Preston, K. B., & Jean-Louis, K. (2020). A Community Service Organization Focused on the Arts to Develop Empathy in Pharmacy Students. American Journal of Pharmaceutical Education, 84(4), 7723.

Remein, C. D., Childs, E., Pasco, J. C., Trinquart, L., Flynn, D. B., Wingerter, S. L., Bhasin, R. M., Demers, L. B., & Benjamin, E. J. (2020). Content and outcomes of narrative medicine programmes: A systematic review of the literature through 2019. BMJ Open, 10(1), e031568.

Stewart, D., Whittlesea, C., Dhital, R., Newbould, L., & McCambridge, J. (2020). Community pharmacist led medication reviews in the UK: A scoping review of the medicines use review and the new medicine service literatures. Research in Social & Administrative Pharmacy: RSAP, 16(2), 111–122.

Stewart-Ferrer, S., & Rasmussen, A. J. (2019). ‘Human First’: Teaching close reading and creative writing to medical students. Tidsskrift for Forskning i Sygdom Og Samfund, 16(31).

Tanuma, K., Watanabe, F., Maeda, H., Saitoh, N., & Kamei, M. (2019). Validation of a Reorganized Training Program Using a Cognitive Behavioral Therapy Approach to Enable Community Pharmacists to Provide Empathic Patient Counseling. Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan, 139(1), 97–106.

Tong, A., Sainsbury, P., & Craig, J. (2007). Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care, 19(6), 349–357.

Vermeir, P., Vandijck, D., Degroote, S., Peleman, R., Verhaeghe, R., Mortier, E., Hallaert, G., Van Daele, S., Buylaert, W., & Vogelaers, D. (2015). Communication in healthcare: A narrative review of the literature and practical recommendations. International Journal of Clinical Practice, 69(11), 1257–1267.

Weiner, S. J., Schwartz, A., Weaver, F., Goldberg, J., Yudkowsky, R., Sharma, G., Binns-Calvey, A., Preyss, B., Schapira, M. M., Persell, S. D., Jacobs, E., & Abrams, R. I. (2010). Contextual errors and failures in individualizing patient care: A multicenter study. Annals of Internal Medicine, 153(2), 69–75.

Wells, K. M., Thornley, T., Boyd, M. J., & Boardman, H. F. (2014). Views and experiences of community pharmacists and superintendent pharmacists regarding the New Medicine Service in England prior to implementation. Research in Social and Administrative Pharmacy: RSAP, 10(1), 58–71.

WHO | Process of translation and adaptation of instruments. (n.d.). WHO; World Health Organization. Retrieved May 19, 2020, from

WMA - The World Medical Association-WMA Declaration of Helsinki – Ethical Principles for Medical Research Involving Human Subjects. (n.d.). Retrieved June 28, 2018, from

Wolters, M., van Hulten, R., Blom, L., & Bouvy, M. L. (2017). Exploring the concept of patient centred communication for the pharmacy practice. International Journal of Clinical Pharmacy, 39(6), 1145–1156.

Yang, N., Xiao, H., Cao, Y., Li, S., Yan, H., & Wang, Y. (2018). Does narrative medicine education improve nursing students’ empathic abilities and academic achievement? A randomised controlled trial. The Journal of International Medical Research, 46(8), 3306–3317.

Zimmermann, M. (2013). Integrating medical humanities into a pharmaceutical care seminar on dementia. American journal of pharmaceutical education, 77(1), 16.




How to Cite

Graabæk, T., Rasmussen, A. J., Mai, A.-M., Rossing, C., & Hedegaard, U. (2022). Can literary reading and writing improve pharmacists’ medication counselling? A feasibility study of pharmacists’ efforts to achieve competence in narrative medicine. Pharmacy Education, 22(1), p. 744–760.



Research Article