This narrative demonstrates the complexity of the narratives and the breadth of professionalism described. While the narrative demonstrates many aspects of professional behavior from being thorough, to responsibility, to spending time giving explanations, the main focus of the student is the respect given to patients who chose to use the ED for primary care. Repeatedly, students describe similar situations where parents bring young children in for mild fever or where adult patients express the need for refills on chronic care medication, all while physicians

and staff respect their decisions and clinical wishes. The second most common theme noted in Inhibitors,research,lifescience,medical narrative analysis was spending time taking care of patients, patients’ education, and understanding was common. One student noted the following; We had a 11 year old girl whose mom brought her in because she had been PI3K inhibitor drugs running low grade fevers, coughing, and just feeling overall under the weather for a couple weeks. We started to Inhibitors,research,lifescience,medical explain to the mom that this was a virus, her daughter was otherwise fine, the fevers were not dangerous, and it is safe to go home, but the mom broke in and

wanted a complete explanation of why this is not Inhibitors,research,lifescience,medical appendicitis. My attending could have gotten short with this mother, but instead he sat down and patiently explained our physical exam, what we look for, and why we ask the questions we did. He took a full 20 minutes allaying this mom’s fears and convincing her that we really did rule out all the things she was afraid her daughter might have. If he had not taken the time to explain Inhibitors,research,lifescience,medical everything, the mom would have likely been back the next day because her concerns had not been addressed. Again, like the previously discussed narrative, this story involves multiple aspects of professionalism from respect to communication.

The key feature however that the student was trying to portray here was the time spent Inhibitors,research,lifescience,medical answering questions and giving the mother adequate support. Narratives within different themes focused on various content. One content nearly area that was prevalent in EM was pain management. In this content area students would often comment about the appropriate use of narcotic medication and interactions with patients with drug seeking behavior. The narratives of this content were categorized in a variety of themes. Some were positive narratives that could be classified under the theme of spending time and others were negative narratives, that were classified under using inappropriate comments (behind a patients back). Perhaps the most common theme noted for this content focus was managing communication challenges with patients and families.