— LETTER TO THE EDITOR —

Six-Word Stories Offer a New Opportunity for Medical Students' Reflection

Sarah E. Stumbar, MD, MPH | Marthena Phan | David F. Gomez, MD | Tori Ehrhardt, MD | Larissa Andrade, MD | Phoebe Hughes, MD | Muhammad Hamza Mir, MD

PRiMER. 2022;6:8.

Published: 3/25/2022 | DOI: 10.22454/PRiMER.2022.644399

To the Editor:

Short stories comprised of a very low number of carefully chosen words and, consequently, few or no full sentences, are sprinkled throughout popular writing and classroom assignments. In particular, 55-word stories have become a succinct, creative vehicle through which medical professionals process their experiences.1 These notably short pieces of creative writing promote reflection and introspection, as well as humanistic and ethical patient care.2,3

The 55-word story format has been adapted to include six-word stories that, despite being staggeringly short, still tell compelling narratives and can foster pointed reflection on experiences during health professions training.4 However, six-word stories have yet to be consistently integrated into undergraduate medical education; there is little written on the topic. During a narrative medicine course at our medical school, fourth-year students were, among other assignments, tasked with writing three six-word stories exploring their reasons for pursuing a career in medicine.

After writing their six-word stories at home, students attended a small group session where they projected their stories on a screen, read them out loud, and provided feedback to their peers.

There were discussions about the choice of single words, the order of words, and punctuation. The students agree that the hardest thing about writing a six-word story was to make sure every word added to the story, particularly as there are no fillers or background. One student author of this paper writes, “The self-reflection these stories evoked in me was surprising. I found that once I selected a theme, the thoughts started pouring out. Then…I was pushed to…use only the words that carried the most meaning to me. It was an unexpected and beautiful practice of intentionality that both challenged me and brought me joy.”

Below are the sets of six-word stories written by five of the students from the narrative medicine elective. They evidence creativity, precision, and introspection, perhaps enhanced by the limited word count.

I.

Unknown world of the deepest connections.

Feet grounded, mind sharp, heart fulfilled.

Preserving dignity throughout life, into death.

-Tori Ehrhardt

II.

At the end, everyone is vulnerable.

Listening to people. Learning new perspectives.

Loud monitors. Your lullaby. Rest peacefully.

-Larissa Andrade

III.

Why medical school? I don’t know.

Saving lives. Thought it sounded cool.

Couldn’t see myself doing anything else.

-David Gomez

IV.

big picture interventions, turned individual impacts

following footsteps to live her example

lab benches don’t tell good stories

-Phoebe Hughes

V.

Dusty roads, his steps are bigger.

Long line outside of fearful faces.

Continue a legacy, honor the oath.

-Muhammad Hamza Mir

 

As evidenced by the stories above, students wrote about the influences of their parents and mentors, their desire to connect to and help patients, and end-of-life care. Their stories begin to show the importance of decisive thought processes, that may assist in deciphering priorities in medical decision-making and patient-centered communication. In summary, while six-word stories are a profound vehicle for focused reflection, future research should explore how this assignment can deepen and clarify reflection among medical students.

Acknowledgments

Disclaimer: The six-word stories included in this letter were submitted by the authors. Quotes and reflections are included with the authors' expressed permission.

References

  1. Saperstein AK, Woodward SL, Cirks BT, Wendling AS, Smith MD. 55-word stories about medical students’ clerkship experiences. Mil Med. 2016;181(11):1401-1401. doi:10.7205/MILMED-D-16-00195
  2. Fogarty CT. Fifty-five word stories: “small jewels” for personal reflection and teaching. Fam Med. 2010;42(6):400-402.
  3. Childress MD. From doctors’ stories to doctors’ stories, and back again. AMA J Ethics. 2017;19(3):272-280. doi:10.1001/journalofethics.2017.19.3.nlit1-1703
  4. Calilung KC, Lapiz-Bluhm MD. Integrating nursing education in students’ extracurricular activities: Students’ motivations and benefits. Journal of Comprehensive Nursing Research and Care. 2019;4(1):1-7. doi:10.33790/jcnrc1100133

Lead Author

Sarah E. Stumbar, MD, MPH

Affiliations: Florida International University Herbert Wertheim College of Medicine, Miami, FL

Co-Authors

Marthena Phan - Florida International University Herbert Wertheim College of Medicine, Miami, FL

David F. Gomez, MD - Florida International University Herbert Wertheim College of Medicine, Miami, FL

Tori Ehrhardt, MD - Florida International University Herbert Wertheim College of Medicine, Miami, FL

Larissa Andrade, MD - Florida International University Herbert Wertheim College of Medicine, Miami, FL

Phoebe Hughes, MD - 1Florida International University Herbert Wertheim College of Medicine, Miami, FL

Muhammad Hamza Mir, MD - Florida International University Herbert Wertheim College of Medicine, Miami, FL

Corresponding Author

Sarah E. Stumbar, MD, MPH

Correspondence: Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8th Street, AHC2-483, Miami, FL 33199. 607-592-9587. Fax: 305-348-1495

Email: sstumbar@fiu.edu

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