Integrating narrative medicine into post-genocide Rwandan healthcare: a call for trauma-responsive medical education

This narrative review examines the potential integration of narrative medicine into Rwanda's post-genocide healthcare system, where long-term psychological consequences continue to shape patient experiences and clinical practice. Despite significant improvements in health system performance since 1994, Rwanda's post-genocide context continues to shape emotionally demanding clinical encounters for patients and healthcare professionals. Narrative medicine refers to the clinical and educational capacity to attend to, interpret, and respond ethically to patients' illness stories. International literature suggests that narrative-based education may strengthen social and relational competencies, including empathy, perspective-taking, reflective capacity, and communication; however, these findings are context-dependent and require Rwanda-specific evaluation. In this review, the Chinese clinical narrative thinking framework serves as one possible analytic scaffold, not a model to be transferred uncritically. Its value is that it organizes narrative competence into four teachable clinical domains: narrative diagnostic thinking, narrative decision-making, narrative patient education, and narrative care or intervention. These domains are considered alongside foundational narrative medicine, illness narrative, reflective practice, and trauma-informed care frameworks. Although Rwanda has strong traditions of storytelling, testimony, and collective healing, these community and public practices are not direct equivalents of clinical narrative medicine. Narrative medicine has not yet been systematically integrated into Rwandan medical education or routine clinical practice, and any future integration would require trauma-sensitive safeguards, careful professional boundaries, and empirical evaluation. This review integrates deliberately selected global and context-specific literature to examine the theoretical underpinnings of narrative medicine, its significance to Rwanda's sociocultural storytelling and collective healing, and the gaps in medical education. While Rwanda-specific empirical evidence remains limited, the convergence of ongoing mental health needs, national workforce expansion, and strong narrative traditions presents a timely opportunity to develop trauma-responsive healthcare models relevant to post-conflict societies globally.