Building character: A creative writing intervention to encourage clinician reflection on the social determinants of health

Research into the power of literature to enhance empathy supports the inclusion of reflective reading and writing in medical humanities programmes around the world. Building on additional research into perspective-taking, investigators piloted an intervention using guided fiction writing to focus participant attention on risky health behaviours and the social determinants of health. A mix of clinical and nonclinical participants at a medical humanities workshop were asked to develop a fictional character engaging in a negative health behaviour and write about that individual in two prescribed scenes. The exercises were found to be valuable and feasible by participants and highlighted themes in effective practice, including cultural competence. Analysis of the participants’ writing and the session transcript indicated increases in awareness of the social and economic determinants of health and suggested that examining modifiable risk behaviours in non-clinical settings through fiction writing may be an important tool in enhancing provider empathy.