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In:Dialogues of the Clinic: Encounters across medicine and beyond
Edited by Mariaelena Bartesaghi and Shelby Forbes
[Dialogue Studies 36] 2026
► pp. 150–174

Chapter 6
Reimagining the potential of eliciting a patient’s story

Reclaiming the “voice of the lifeworld” in medicine through dialogue

 | Eastern Virginia Medical School
This content is being prepared for publication; it may be subject to changes.
Abstract
Patients seek opportunities to share their stories with physicians as part of a meaningful clinical relationship. Although communication skills such as expressing empathy and eliciting patient narratives are central to medical education, the dialogic potential of clinical encounters often remains unrealized. Drawing on Raimo Puustinen’s claim that dialogue is fundamental to medical examination and treatment, this chapter argues that amplifying dialogue in medical education can strengthen both clinical information gathering and patient rapport. After briefly tracing historical models of the patient-provider relationship, the chapter examines the concepts of empathy and narrative and their relationship to dialogue. It then considers how communication skills are currently taught in medical training. Using transcribed encounters between medical students and standardized patients in clinical exam settings, the chapter demonstrates how open-ended questions at the beginning of interviews can transform routine exchanges into dialogic encounters that foster genuine empathy while also facilitating more effective and efficient clinical communication.
Article outline
  • 1.Introduction
  • 2.Prevailing medical models
  • 3.Story, empathy, and dialogue
  • 4.Medical education: Communication skills
  • 5.Methods
  • 6.Case analysis
  • 7.Discussion
  • 8.Conclusion
  • References
References (52)
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