Carpenter et al. Respond

We wish to thank Brason Lee for a thoughtful suggestion on one component of scientific dissemination, which we had not fully contemplated: communication and the potential for personal narrative. In the past decade, exemplar stories have been used to convey individual experiences in trying to achieve optimal, research-based outcomes, and these narratives often extend beyond societal divisions of medicine, social science, and public services.¹ Personal narratives provide a glimpse into the complexity inherent in putting formal, precision-focused research reports into the real world. Evidence-based medicine leaders suggest that the next evolution of research-based practice will combine traditional critical appraisal with pertinent stories that tie researchers to clinicians and their patients.² Narrative methods have also been used to nurture scientific manuscript penetration into medical practice as an evolving paradigm of translational medicine.³ Educators are using personal illness storytelling to help medical students incorporate empathy into routine practice early in their careers.⁴ Training health care professionals using humanistic storytelling to convey the individual impact of key medical decisions cultivates relationship-centered care delivery.⁵ Similarly, at the population health level narratives have been used to successfully address social disparities in the primary and secondary prevention of illness.⁶ For policy-related audiences, the preference of narrative versus a data-based presentation my vary according to gender, age, and political ideology.⁷ Finally, personal narratives can also be used for sharing lessons learned among researchers (see the Narrative Library Web site at http://www.makeresearchmatter.org/narrative-library/about-the-narrative-library.aspx). However, a narrative approach to communicating research findings is not without limitations. Excessive focus on the story rather than the data risks tokenism and undue attention to the entertaining raconteur at the expense of the pioneering scientist. In addition, some stories cannot or should not be told in public forums.⁸

Contemplating a more inclusive dissemination and implementation research reporting framework within the context of narrative communication also suggests challenging barriers. Manuscripts pass through a rigorous peer-review process, often including unpaid and over-tasked volunteer editorial board members or reviewers with tangential understanding of the topic or methods. Reviewers’ understanding of the potential for narrative to enhance the impact, distribution, and uptake of research is likely to be limited and will require time to penetrate the psyche of editorial boards and peer referees across specialties. Advocates for a narrative approach to convey the positive, negative, or equivocal impact of research into the lives of real persons will need to educate reviewers of these benefits within the context of contemporary rigorous scientific reporting.