The Narrative Gym for Medicine: Introducing the ABT Framework for Medical Communication with Peers, Professionals, and the Public

By Randy Olson

Communication is central to medicine, yet the COVID-19 pandemic revealed major shortcomings in the communication skills of medical professionals. As the world continues to drown in excess amounts of information (communicated ever more rapidly by social media), the ability to maintain focus becomes increasingly difficult.

Enter the ABT.

For more than a decade we have been developing the ABT Framework as both a model for narrative structure and a tool for strengthening what we have termed “narrative intuition.” In this, the 6th version of the Narrative Gym series (following the introductory version, then business, law, politics, and science) we offer up two things: 1) the model, 2) its applications.

Perhaps the most powerful part of the book is chapter 7 where ABT founder Randy Olson teams up with Navid Ghaffari, MD to explain specifically how to apply the ABT within the medical profession. The book is brief, to the point, and most importantly, practical.

• Language: English
• Publisher: Randy Olson
• Release date: Oct 9, 2023
• ISBN: 9798215473177

Randy Olson

Randy Olson earned his Ph.D. at Harvard University and achieved tenure at the University of New Hampshire before resigning and moving to Hollywood, obtaining an M.F.A. from the University of Southern California School of Cinema, and embarking on a second career as a filmmaker. Since film school he has written and directed the critically acclaimed films Flock of Dodos: The Evolution-Intelligent Design Circus (Tribeca, '06, Showtime) and Sizzle: A Global Warming Comedy (Outfest, '08), and co-founded The Shifting Baselines Ocean Media Project, a partnership between scientists and Hollywood to communicate the crisis facing our oceans.

Book preview

THE NARRATIVE GYM

FOR MEDICINE

Introducing the ABT Framework for Medical Communication with Peers, Professionals, and the Public

By Randy Olson

THE NARRATIVE GYM FOR MEDICINE:

Introducing the ABT Framework for Medical Communication with Peers, Professionals, and the Public

Randy Olson

Copyright © by Prairie Starfish Press

October 2023

All rights reserved. No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the publisher, except it the case of brief quotations embodied in critical reviews and certain other noncommercial uses permitted by copyright law. For permission requests, email the author at [e-mail]

Book Cover Design by ebooklaunch.com

Edited by Adina Yoffie

TABLE OF CONTENTS

Foreword by H. Blumberg, MD & I. Ofotokun, MD

1 One Word: Clarity

2 ABT Framework: The Primary Level

3 ABT Framework: The Secondary Level

4 ABT Build, Step 1: Building a Better But

Bomb!

5 ABT Build, Step 2: The Context Blues

6 ABT Build, Step 3: The Two Moments

7 Applying the ABT Framework In Medicine

8 The Future is Narrative

Appendix 1: The ABT Is Everywhere

Appendix 2: The Working Circles Model

Appendix 3: The Misinformation Narrative

Appendix 4: Key References

The ABT Development Card

Acknowledgements

FOREWORD BY

Henry Blumberg, MD and

Igho Ofotokun, MD

Traditionally, scientific communications training has focused on how to communicate with other scientists or medical professionals BUT as evidenced by the COVID-19 pandemic, in today’s world there is an urgent need to be able to also communicate science and medicine with a variety of stakeholders including the public, THEREFORE we have implemented scientific communications training for junior investigators using the ABT Framework.

Despite the importance of effective scientific communications, including those focused on the community and lay public, researchers and medical professionals rarely receive training on how to communicate outside of the academic environment. Researchers and other medical professionals receive training on how to effectively communicate in a scientific language about their scientific findings to other investigators and clinicians but struggle with how to relay this information to a broader non-scientific audience. To be effective, translational scientists, including physician-scientists, must be skilled communicators with the ability to engage with clarity with all stakeholders in the translational spectrum and across diverse social, cultural, economic, and scientific backgrounds, including patients, caregivers, and community members. This ideal, coupled with a strong desire by our trainees to improve in this area, propelled the leadership of the Georgia Clinical and Translational Science Alliance (Georgia CTSA, one of the NIH-funded Clinical and Translational Science Awards) Research Education Program to seek additional scientific-communications training for our students and trainees.

We discovered Dr. Randy Olson after hearing him on the Medscape podcast of Dr. Eric Topol, Medicine and the Machine, reached out, and established a collaboration using the ABT (And, But, Therefore) Framework as a platform to provide scientific-communications training to our current and former trainees. In the fall of 2022, we piloted a scientific-communications training course directed by Dr. Olson, who has conducted similar training, with glowing reviews, for a number of different groups, including Pfizer, Genentech, the World Bank, Global Health Laboratories and selected universities. We were attracted to the ABT Framework because of its underlying philosophy (and simplicity)— narrative structure is at the core of all effective and engaging communication. Traditional approaches to communicating research findings to the public have often been based on paternalistic views of communication, in which researchers talk at the public rather than engaging them in an active, non-condescending dialogue. This traditional approach often not only fails to lead to meaningful engagement but is counterproductive, leading to public discouragement and distrust in research endeavors, as was the case during the COVID-19 pandemic.

Narrative training, on the other hand, works to build an intuitive feel for how to create solid narrative structure through simplicity and repetition, using the ABT narrative template. Our trainees had the opportunity to learn the difference between Narrative Intuition (often used in storytelling as an effective mechanism for communicating with the public) and Numerical Intuition (reliance on large data sets, which is generally emphasized in medicine and science). The ABT template is anchored to the concept that effective communication needs a framework (Agreement, Contradiction, Consequence). That framework begins with agreement (the And), meaning what is known to the audience, followed by the introduction of a singular narrative with a problem or contradiction (the But), and then proceeds to the actions needed to address the problem or consequences (the Therefore). The development of narrative strength requires a focused and sustained effort that takes into consideration the perspective of the public, regardless of their background, and, therefore, naturally attracts the attention of the audience in an engaging manner (emphasizing Narrative Intuition).

Our pilot scientific-communications course, led by Dr. Olson based on the ABT Framework was very successful. Georgia CTSA trainees and faculty who participated in the training rated it highly. They noted that it was thought-provoking and has the potential to shift the paradigm in the quest to develop an effective approach to scientific communications, both in the scientific community and, importantly, when engaging the public. The Narrative Gym component provided an additional opportunity for practice in the use of the ABT Framework with others more experienced in the approach. It was thought to be innovative, as it moves knowledge taught during the didactic phase from memorization into Narrative Intuition—a core of effective communication. Based on the success of the pilot, we have developed a new graduate-level scientific- communications course, approved by the Laney Graduate School of Emory University, that has become part of our clinical and translational research training program. Targeted at early-stage translational scientists, this course based on the ABT Framework will adopt the narrative training into our curriculum—an approach that we believe will enhance the ability of our budding translational scientists to effectively communicate their scientific findings to a broader audience, including the lay public.

This new book by Dr. Olson is focused on providing the medical community, including clinicians and investigators, with the skills to enhance their communication using the ABT Framework. It provides Dr. Olson’s approach using the ABT Framework in a concise and entertaining fashion.

CHAPTER ONE

ONE WORD: CLARITY

In 1975 a postdoctoral fellow at the Salk Institute in La Jolla, California, published a paper in The New England Journal of Medicine titled Medical Obfuscation: Structure and Function. The essay pointed out that the medical community suffers widely from the communication malady known as obfuscation. This refers to the tendency to present things in a confusing and overly complicated manner.

The author talked about the cost of this in terms of wasted time and resources. It was such a well-written paper that it should have had a major impact. If it had, the medical world today would communicate much better than it does.

But that didn’t happen. The author’s words of warning fell largely on deaf ears. Today the situation is worse than ever, as evidenced by the disastrous communication mistakes made throughout the COVID-19 pandemic.

Therefore, something must change. Obfuscation is forever the enemy of effective communication. What we seek is its opposite: clarity. In fact, nothing in communication makes sense, except in the light of clarity. It’s what we want, which means that what we need is a tool that can enable us to work toward it.

That is what this book is about: the introduction of a new tool for communication and even critical thinking itself. It is a tool that can help us reverse a century-long descent into the abyss of obfuscation. It’s time to work our way back to clarity.

JURASSIC ADVICE

Okay, wait—before we go on, there’s more to that story of the 1975 paper.

The author was quite possibly the greatest gift ever to the entire