Development and Validation of Narrative Competence Scale for Medical Students

Abstract In medical practice, narrative competence is pivotal in enabling physicians to better comprehend their patients' experiences, nurture empathy, and promote person-centered care. However, despite its significance, a standardized tool for evaluating this competence still needs to be developed. This study aimed to address this gap by developing the Narrative Competence Scale (NCS) for medical students. The initial version of the scale consisted of 57 items across four dimensions and eleven sub-dimensions, refined through three rounds of the Delphi method with eleven experts in medical education. The scale was then preliminarily tested with 200 fifth and sixth-year medical students in Taiwan. The Confirmatory Factor Analysis results indicated a fit for the four-factor model, with critical indices such as RMSEA = .055, SRMR = .045, and CFI = .970, among others, emphasizing the model's robust integrity. The scale demonstrated suitable convergent validity (AVE = .497-.698, CR = .798-.902) and discriminant validity, with the square roots of the AVE values surpassing inter-dimensional correlations. High internal consistency was reflected in Cronbach's alpha coefficients (0.797-0.972). In conclusion, the NCS has been established as a reliable and effective tool for assessing narrative competence in medical students, holding immense potential as both a research and educational instrument in narrative medicine for enhancing the application and comprehension of patient narratives in medical education. Keywords: Medical student, Narrative competence, Narrative medicine, Scale development.